Article Type
Changed
Thu, 04/06/2017 - 15:10
Display Headline
Feds Cut Medicaid Pay for Preventable Conditions

As of July 1, Medicaid will no longer pay heath care providers for preventable, health care–acquired injuries or illnesses. The final rule, which implements a part of the Affordable Care Act, takes another step forward in reducing unnecessary health care costs, Dr. Donald M. Berwick, administrator for the Center for Medicare and Medicaid Services, said during a press briefing.

Provider-preventable conditions that will no longer be reimbursed include catheter-associated vascular infections, pressure ulcers, blood incompatibilities, air embolisms, surgical site infections, wrong surgery, wrong-patient surgery, and wrong surgical site, Dr. Berwick said.

The rule is based on similar measures already implemented under Medicare and independently by many states, Dr. Berwick said. Currently, 27 states prohibit payment for health care–acquired conditions and 17 do not pay for preventable conditions, according to Cindy Mann, director of CMS’s Center for Medicaid, CHIP, and Survey and Certification.

The Washington State Medicaid program is considering ways to increase accountability-based payment systems, according to its chief medical officer, Dr. Jeffery Thompson, who spoke during the briefing. Dr. Thompson said the state has determined it could save as much as $100 million, one-sixth of its budget, by eliminating 30-day hospital readmissions.

Under the provision, states will have the flexibility to expand the list of conditions to not be reimbursed, pending CMS approval. States also will have the option to implement the provisions between July 1, 2011, and July 1, 2012.

References

Author and Disclosure Information

Publications
Topics
Sections
Author and Disclosure Information

Author and Disclosure Information

As of July 1, Medicaid will no longer pay heath care providers for preventable, health care–acquired injuries or illnesses. The final rule, which implements a part of the Affordable Care Act, takes another step forward in reducing unnecessary health care costs, Dr. Donald M. Berwick, administrator for the Center for Medicare and Medicaid Services, said during a press briefing.

Provider-preventable conditions that will no longer be reimbursed include catheter-associated vascular infections, pressure ulcers, blood incompatibilities, air embolisms, surgical site infections, wrong surgery, wrong-patient surgery, and wrong surgical site, Dr. Berwick said.

The rule is based on similar measures already implemented under Medicare and independently by many states, Dr. Berwick said. Currently, 27 states prohibit payment for health care–acquired conditions and 17 do not pay for preventable conditions, according to Cindy Mann, director of CMS’s Center for Medicaid, CHIP, and Survey and Certification.

The Washington State Medicaid program is considering ways to increase accountability-based payment systems, according to its chief medical officer, Dr. Jeffery Thompson, who spoke during the briefing. Dr. Thompson said the state has determined it could save as much as $100 million, one-sixth of its budget, by eliminating 30-day hospital readmissions.

Under the provision, states will have the flexibility to expand the list of conditions to not be reimbursed, pending CMS approval. States also will have the option to implement the provisions between July 1, 2011, and July 1, 2012.

As of July 1, Medicaid will no longer pay heath care providers for preventable, health care–acquired injuries or illnesses. The final rule, which implements a part of the Affordable Care Act, takes another step forward in reducing unnecessary health care costs, Dr. Donald M. Berwick, administrator for the Center for Medicare and Medicaid Services, said during a press briefing.

Provider-preventable conditions that will no longer be reimbursed include catheter-associated vascular infections, pressure ulcers, blood incompatibilities, air embolisms, surgical site infections, wrong surgery, wrong-patient surgery, and wrong surgical site, Dr. Berwick said.

The rule is based on similar measures already implemented under Medicare and independently by many states, Dr. Berwick said. Currently, 27 states prohibit payment for health care–acquired conditions and 17 do not pay for preventable conditions, according to Cindy Mann, director of CMS’s Center for Medicaid, CHIP, and Survey and Certification.

The Washington State Medicaid program is considering ways to increase accountability-based payment systems, according to its chief medical officer, Dr. Jeffery Thompson, who spoke during the briefing. Dr. Thompson said the state has determined it could save as much as $100 million, one-sixth of its budget, by eliminating 30-day hospital readmissions.

Under the provision, states will have the flexibility to expand the list of conditions to not be reimbursed, pending CMS approval. States also will have the option to implement the provisions between July 1, 2011, and July 1, 2012.

References

References

Publications
Publications
Topics
Article Type
Display Headline
Feds Cut Medicaid Pay for Preventable Conditions
Display Headline
Feds Cut Medicaid Pay for Preventable Conditions
Sections
Article Source

PURLs Copyright

Inside the Article