Archive for September, 2014

CMS Explores Consolidated Payment System

Tuesday, September 16th, 2014

Over the last several years, CMS has worked with the Medicare Payment Advisory Committee to streamline payments for a number of patient services and procedures. Each group has proposed changes to Medicare billing that, if adopted, could streamline and reduce annual healthcare spending for the program.

The current payment system allows for differing payments for the same service depending on where and by whom it was performed. Hospital outpatient departments, for example, receive a higher payment than a physician’s office for the same procedure. However, differentials are also present when measuring payments received by the same physician for the same procedure based on how it was coded.

Several elements contribute to the billing differences that CMS and MedPAC hope to eliminate, including packaged versus separate payments; where providers choose to perform services (and patients choose to receive them); and different methods of weighing payments between different facilities.

Proposed changes include updates to this year’s physician fee schedule and limiting billing to either physician rates or hospital rates. The larger question this creates, however, is which system is the best to determine payment rates at all

A site-neutral payment program is slowly developing: beginning in 2016, long-term care hospital pay rates will shift to align with existing inpatient PPS rates. In the meantime, both CMS and MedPAC continue to identify inconsistencies in payments and potential solutions for them.

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Union Protections Extend to Minnesota Home Care

Friday, September 5th, 2014

The Service Employees International Union (SEIU) will now extend its benefits to home-care workers in Minnesota.

Home-care workers voted last week by a 60-40 split to join the SEIU. Such workers, who largely care for their own relatives, are paid by Medicaid to provide non-medical assistance to elderly or disabled patients (including feeding, dressing, and driving them to complete errands). Under the SEIU, such workers will now have collective bargaining rights to campaign for higher wages and other benefits.

This vote makes Minnesota the latest in a series of states that have extended union privileges to home health workers, even as the union fights several cases challenging mandatory union dues for workers. It is also consistent with the announcement of FLSA extensions to existing minimum wage requirements made earlier this summer.

It remains to be seen whether home-care workers in other states will vote to unionize, and what impact that may have on home care agencies in those states. Regardless of the impact, PRN Funding’s home health care factoring programs can help agencies that struggle to meet rising operating costs. Visit PRN Funding to learn more about home health care factoring and to apply today.

CVS Health Tobacco Sales Go Up in Smoke Early

Wednesday, September 3rd, 2014

To reinforce its position as a health-focused company, CVS Caremark has pushed up its plan to cease tobacco sales at retail locations by a full month. Beginning today, tobacco products are no longer available at any CVS store. The company is also rebranding itself as CVS Health.

Reactions to the decision are mixed: research to be published today in Health Affairs suggests that tobacco sales bans in San Francisco and Boston retail pharmacies correlate to an approximately 13 percent drop in tobacco purchasers, and CVS Health’s chief medical officer estimates that a nationwide ban could reduce tobacco-related deaths by tens of thousands every year. Public health advocates also cheer the move.

On the other hand, other retail pharmacies are reluctant to jump on the “ban”dwagon and cite tobacco cessation products as the more effective tool against tobacco use. CVS Health is targeting tobacco use through expanded cessation services, which they will provide at their 7,000-plus retail locations.

CVS Health is also expanding its relationship with health care providers to increase the quality of care that patients can receive at existing and future CVS walk-in clinics.

The financial impact of ending tobacco sales remains to be seen, but CVS Health executives are confident that the decision will “position it as a broader provider of basic health services”.