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Why home health care is suddenly harder to come by for Medicare patients

The decision came out of the blue. "Your husband isn't going to get any better, so we can't continue services," an occupational therapist told Deloise "Del" Holloway in early November. "Medicare isn't going to pay for it."

3 Feb 2020

New round of Medicare readmission penalties hits 2,583 hospitals

Medicare cut payments to 2,583 hospitals Tuesday, continuing the Affordable Care Act's eight-year campaign to financially pressure hospitals into reducing the number of patients who return for a second stay within a month.

1 Oct 2019

Class-action lawsuit seeks to let Medicare patients appeal gap in nursing home coverage

Medicare paid for Betty Gordon’s knee replacement surgery in March, but the 72-year-old former high school teacher needed a nursing home stay and care at home to recover.

12 Aug 2019

Medicare recipients may pay more for generics than their brand-name counterparts, study finds

Medicare Part D enrollees may pay more out of pocket for high-priced specialty generic drugs than their brand-name counterparts, according to new research by health policy experts at Vanderbilt University Medical Center and the University of North Carolina at Chapel Hill.

2 Jul 2019

Hospitals chafe under Medicare’s new payment rule for off-campus clinics

Eric Lewis' plans for expansion have derailed. As chief executive officer of Olympic Medical Center, he oversees efforts to provide care to roughly 75,000 people in Clallam County, in the isolated, rural northwestern corner of Washington state.

26 Apr 2019

Making smarter decisions about where to recover after hospitalization

Every year, nearly 2 million people on Medicare — most of them older adults — go to a skilled nursing facility to recover after a hospitalization. But choosing the facility can be daunting, according to an emerging body of research.

11 Apr 2019

Massachusetts stroke patient receives ‘outrageous’ $474,725 medical flight bill

Kristina Cunningham was in stable condition on an evening in June, when EMTs lifted her gurney into a medical flight, bound for Boston.

21 Dec 2018

Medicare Advantage riding high as new insurers flock to sell to seniors

Health care experts widely expected the Affordable Care Act to hobble Medicare Advantage, the government-funded private health plans that millions of seniors have chosen as an alternative to original Medicare.

15 Oct 2018

Doctors give Medicare’s proposal to pay for telemedicine poor prognosis

The Trump administration wants Medicare for the first time to embrace telemedicine across the country by paying doctors $14 for a five-minute "check-in" phone call with their patients.

10 Oct 2018

Medicare eases readmission penalties against safety-net hospitals

On orders from Congress, Medicare is easing up on its annual readmission penalties on hundreds of hospitals serving the most low-income residents, records released last week show.

28 Sep 2018

ACR cautions policymakers that reducing E/M services can compromise patient access to care

In comments submitted to the Centers for Medicare and Medicaid Services regarding the 2019 Medicare Physician Fee Schedule proposed rule, the American College of Rheumatology cautioned policymakers against implementing a proposal to reduce physician reimbursement for evaluation and management services, arguing that doing so could severely compromise patient access to care and further exacerbate the growing rheumatology workforce shortage.

10 Sep 2018

Trump’s budget proposal swings at drug prices with a glancing blow

President Donald Trump's new budget proposal flirts with combating high prescription drug prices, but industry watchers say the tweaks to Medicare and Medicaid do little more than dance around the edges of lowering the actual prices of drugs.

13 Feb 2018

Why glaring quality gaps among nursing homes are likely to grow if Medicaid is cut

Nursing homes that rely the most on Medicaid tend to provide the worst care for their residents — not just the people covered by the program but also those who pay privately or have Medicare coverage.

30 Sep 2017

Why glaring quality gaps among nursing homes are likely to grow if Medicaid is cut

28 Sep 2017

Shedding new light on hospice care: No need to wait for the ‘brink of death’

A few weeks ago, Kathy Brandt's 86-year-old mother was hospitalized in Florida after a fall. After rushing to her side, Brandt asked for a consult with a palliative care nurse.

7 Sep 2017

Congress squares off over drug pricing and a controversial drug discount program

House Democrats are calling foul on Republican assertions that cuts to a little-known discount drug program will eventually reduce skyrocketing drug prices.

18 Jul 2017

Readmission rates after major cancer procedures depend on patient cohort, hospital characteristics

Readmission rates after complex cancer operations tend to be higher in hospitals that are considered to be vulnerable because they serve as safety nets in their communities or have a high number of Medicaid patients.

1 Jun 2016

PACE: A community-based long-term care model for elderly

A new article "A Case Exemplar for National Policy Leadership: Expanding Program of All-Inclusive Care for the Elderly (PACE)," in the March 2016 Journal of Gerontology, chronicles the beginnings of PACE (Program of All-Inclusive Care for the Elderly) and outlines its rise to nationwide acceptance. PACE is a viable and sustainable model of community-based long-term care that provides coordinated and comprehensive services with an interdisciplinary patient-centered team model that is paid for through Medicare, Medicaid, and other insurers.

7 Mar 2016

Avalere Health study finds that even largest home healthcare providers face very low overall margins

Reflecting the impact of deep reimbursement cuts that have been implemented in recent years, a new study by Avalere Health finds that even the largest home healthcare providers are facing very low overall margins.

21 May 2015

Medicare experiment shows initial promise

Accountable care organizations, an Affordable Care Act model that rewards providers who produce better quality at lower cost, are showing promise in Wisconsin and Iowa. Meanwhile, a top Medicare adviser outlines other needed changes.

22 Sep 2014

MedPAC News and Research

Why home health care is suddenly harder to come by for Medicare patients

New round of Medicare readmission penalties hits 2,583 hospitals

Class-action lawsuit seeks to let Medicare patients appeal gap in nursing home coverage

Medicare recipients may pay more for generics than their brand-name counterparts, study finds

Hospitals chafe under Medicare’s new payment rule for off-campus clinics

Making smarter decisions about where to recover after hospitalization

Massachusetts stroke patient receives ‘outrageous’ $474,725 medical flight bill

Medicare Advantage riding high as new insurers flock to sell to seniors

Doctors give Medicare’s proposal to pay for telemedicine poor prognosis

Medicare eases readmission penalties against safety-net hospitals

ACR cautions policymakers that reducing E/M services can compromise patient access to care

Trump’s budget proposal swings at drug prices with a glancing blow

Why glaring quality gaps among nursing homes are likely to grow if Medicaid is cut

Why glaring quality gaps among nursing homes are likely to grow if Medicaid is cut

Shedding new light on hospice care: No need to wait for the ‘brink of death’

Congress squares off over drug pricing and a controversial drug discount program

Readmission rates after major cancer procedures depend on patient cohort, hospital characteristics

PACE: A community-based long-term care model for elderly

Avalere Health study finds that even largest home healthcare providers face very low overall margins

Medicare experiment shows initial promise

Expanding research and clinical options for children with cancer

Examining how pain could play a direct protective role in the gut

From Puberty to Menopause: Clue’s CEO, Audrey Tsang on the Power of Femtech

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