11 Recent Medicare, Medicaid Issues

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Here are 11 issues dealing with Medicare or Medicaid that occurred in the past week, starting with the most recent.


1. Medicare has risen higher among the list of Republican voters' priorities, replacing the healthcare reform law, according to Kaiser's August Health Tracking Poll.

2. Healthcare revenue growth rates hit a wall in the June 2011 through June 2012 time span, as all nine Standard & Poor's Healthcare Economic Indices dropped from May 2012 figures. The Hospital Medicare Index slumped to 1.96 percent.

3. Medicare accountable care organizations are receiving a lot of publicity, but Medicaid ACOs are beginning to take form as well, as seven states are working to develop and launch their own Medicaid ACOs.

4. A survey found Medicare RAC audits are most common types of audits among hospitals and healthcare providers, with 47 percent of all entities reporting at least one. On average, for-profits reported less than four within the past 12 months, whereas non-profits reported more than six.

5. Medicaid rolls in the United States are likely to surge by 14 million people to a total of 68 million by 2019, and nearly 10 million of the new Medicaid enrollees will be in states that adopt the healthcare law's coverage expansion.

6. The Readmissions Reduction Program, which is part of the Patient Protection and Affordable Care Act, finally reared its head at hospitals, as 2,211 hospitals will be penalized a cumulative $280 million in Medicare funds due to high rates of readmission after discharge, according to an in-depth analysis at Kaiser Health News.

7. Recent history suggests hospitals will continue to struggle to record a positive Medicare margin, especially as healthcare reform and pay-for-performance programs start to take shape. Here are 12 statistics on the overall average Medicare margin at U.S. hospitals from 1999 through 2010.

8. Republican presidential hopeful Mitt Romney named Representative Paul Ryan (R-Wis.) as vice presidential nominee last week. While Mr. Romney and Mr. Ryan agree on repealing President Barack Obama's healthcare law, Mr. Ryan has some ideas of his own to curb the rising expenses of Medicare and Medicaid.

9. Earlier this month, CMS issued its final rule on hospital inpatient reimbursement rates for fiscal year 2013, and according to a recent Moody's Investors Service report, the net 2.8 percent increase in Medicare rates is a "credit positive" for non-profit hospitals in the short term.

10. Utah's Office of the Inspector General looked to delay the state's Medicaid overhaul toward managed care, saying the managed care contracts "lack proper controls."

11. One of the three main characteristics of patients who are likely to be readmitted for heart failure is Medicaid coverage.

More Articles on Medicare and Medicaid:

7 Areas That Will Influence the Finances of Safety-Net Hospitals

Sound Shore, Mount Vernon Hospitals in New York Lay Off 80 Employees

Moody's: Non-Profit Hospital Outlook Negative for Remainder of 2012

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