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In this issue
PDF Icon SmallIncreasing Challenges for Health Exchange Enrollment
As of third quarter 2013, a Gallup poll estimated that 18% of Americans were uninsured, most in the under-26 year old age bracket. The goal of the Obama administration is to provide coverage to at least 7 million beneficiaries during the initial enrollment period. However, when the State and Federal Health Exchanges opened for enrollment on October 1, 2013, the federal site and several state enrollment sites were plagued by technical bugs and difficulties due to the high volume of visitors. (Read more...)

PDF IconRegulatory and Reimbursement Changes Under the FY 2014 IPPS Final Rule
On August 19, 2013, the Centers for Medicare & Medicaid Services released the FY 2014 Medicare Hospital Inpatient Prospective Payment System Final Rule for acute care and long-term care hospitals. The regulation changes noted in the final rule include new rules allowing re-billing for denied admissions for Medicare Part B, and changes to payment details for the Value Based Purchasing and Hospital Acquired Conditions program. The regulation that has caused perhaps the most consternation is the "the 2 midnight rule", requiring that under Medicare Part A, a patient should only be admitted with the expectation that the patient will remain an inpatient for at least two midnights. (Read more...)

PDF Icon Turning Hospitals into Hotels: How Increasing Amenities Could Sacrifice Quality
In a decade where patient safety and quality of care is at the forefront of debates for hospital priorities, a recent article by the New York Times posits that for new U.S. hospital construction and renovation, administrators are marketing private rooms; gourmet food; and, other amenities to draw consumers, instead of improvements in quality or safety. In today's marketplace, consumer perceptions are now bolstered by websites that "grade" healthcare entities, e.g., by using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) in an effort to increase transparency of care. (Read more...)

PDF Icon Prospective Payment System Proposed for QHCs under the ACA
The support and funding of QHCs is recognized as a key component to success for the ACA and healthcare reform. On September 23, 2013 the Centers for Medicare & Medicaid Services released a proposed rule to clarify the original language in the Patient Protection and Affordable Care Act (ACA) regarding developing a prospective payment system for Federally Qualified Health Centers (QHC). Under the proposed rule, payments for primary care and preventative services rendered to more than 21 million people at almost 9,000 QHC sites nationwide will receive an estimated 30% increase in payments beginning on October 1, 2014 and will have to pay no more than 20% in copayments under the ACA. (Read more...)

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