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Tag Archive | "Home health"

Capital Thinking Podcast

After a solemn week in the House of Representatives devoted to recognizing and remembering the victims of the Arizona shootings, the White House has instructed that Congress get back to work and on with its legislative business.  Therefore, Majority Leader Eric Cantor announced that the House will resume “thoughtful consideration” of the health care reform repeal bill this week.  Beginning Tuesday, seven hours of debate will be allowed on the bill with the final vote to occur on Wednesday.  The rules will also allow for one Democratic amendment by Rep. Jim Matheson (D-UT) that would provide for a permanent fix to Medicare’s sustainable growth rate formula, preventing dramatic cuts in physician reimbursements under Medicare.  Congressional Democrats were vocal in their opposition to the repeal bill, noting that it would eliminate important consumer protections, leave millions without insurance, and add to the deficit. Preliminary analysis by the Congressional Budget Office supported this position by determining that repealing the overhaul bill would cost $230 billion over ten years.  It is largely expected to pass due to the Republican majority, but will likely not gain any traction in the Senate.  On Thursday, House Republicans plan to bring up their bill instructing the committees to draft replacement legislation.  Committee organization is also expected to resume, and announcements on Democratic Members’ placement on Committees and subcommittees should be announced this week.

Analysis from the Institute of Medicine’s public meeting last week on what constitutes the definition of “essential benefits” is expected to be a hot topic.  The health reform law required that the IOM analyze and develop criteria for a definition of benefits that all plans sold through an insurance exchange will have to offer.  The IOM will likely publish a report of its findings in September.  However, the process is still in its early stage.  The Bureau of Labor and Statistics is required to find out what the typical employer-sponsored health plan covers, while the Department of Health and Human Services will ultimately determine the final definition.

Last week the Medicare Payment and Advisory Commission (MedPAC) finalized its recommendations for its upcoming March report to Congress.  Of note, the Commission voted to recommend to Congress that inpatient and outpatient Medicare hospital payments rise by 1 percent in fiscal 2012, that payment rates under the physician fee schedule should increase by one percent, and backed a first-ever co-pay for home health care services, despite concerns about the financial burden it might affect beneficiaries.  Chairman Glenn Hackbarth noted that there is ample evidence that the use of co-pays deter over-use of a service. Home health use has increased by 50 percent since 2001 and Medicare spent $19 billion on home health services in 2009. 

Finally, it is also important to note that the National Quality Forum (NQF) has opened a Call for Nominations for organizations and individual subject matter experts to serve on the advisory workgroups of the Measure Applications Partnership (MAP).  MAP will provide recommendations to the Department of Health and Human Services on selecting measures for public reporting and performance-based payment programs.

The multistakeholder workgroups will advise the MAP Coordinating Committee on quality issues and the use of measures to encourage improvement for specific care settings, care providers, and patient populations.  Although the workgroup structure will need to be flexible to respond to the needs of HHS, NQF anticipates the potential for as many as four advisory workgroups in the following areas: clinician, hospital, post-acute care/long-term care, and dual eligible beneficiaries. All nominations must be submitted by Monday, February 7, at 6:00 pm ET.

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