The Federal Financial Forum

From: Medicare Advantage News via AIS Health

By James Gutman, Managing Editor

Trade associations representing Medicare Advantage plans serving disadvantaged populations expressed numerous reservations about the two options CMS last month requested comments on for offering interim relief on star quality ratings for such plans (MAN 12/3/15, p. 1). In their comment letters filed by the Dec. 10 CMS deadline, the associations all thanked CMS for seeking ways to help these financially ailing plan sponsors in the short run, but said they had numerous questions remaining even after a Dec. 3 one-hour CMS conference call on the two options. And they generally voiced doubts about how effective either option would be in granting meaningful relief.

From: The Hill

By Gary Puckrein, Ph.D.

A report just released by the National Minority Quality Forum has found that Medicare is increasing mortality among seniors.1 It describes how the Centers for Medicare & Medicaid Services’ (CMS’s) new reimbursement strategy for medical supplies puts the lives of Medicare beneficiaries at risk by disrupting access to those supplies.

Medicare currently covers a wide variety of medical supplies if they are medically necessary and prescribed by a physician. Historically, Medicare has paid for these supplies on the basis of fee schedules, but several studies have found that Medicare was overpaying for certain items on those schedules. The Competitive Bidding Program (CBP) is being initiated to remedy these overpayments.

Editor’s Note: The following is cross-posted from OIRA Watch.

ACUS, the DQA and Federal Information Dissemination in the Internet Era

Inaccurate and misleading data being disseminated in federal databases threatens public health and fiscal integrity. CMS’s National Provider Identifier database and GSA’s Federal Procurement Data System-Next Generation are only two examples of federal databases that are disseminating data that don’t meet federal data quality requirements. The Data Quality Act provides a process for correcting data in federal databases. For an example of using the DQA to address technical problems with CMS’s star quality rating systems, see CRE’s letter to CMS here. Also see CMS’s detailed response to CRE’s letter here.

From: RevCycleIntelligence

By Jacqueline DiChiara

How do you best measure happiness? Perhaps with much more than a smile. Advancing the art of patient experience is a delicate task within the healthcare space that is often difficult to fully understand. Just because a patient fails to complain, for instance, does not necessarily mean all is well.

Study questions, research methods, and overlooked reporting minutiae are supposedly failing to meet the healthcare system’s demands. Collecting both meaningful and actionable data in real time is often a challenge.

Editor’s Note: The complete report, “Centers for Medicare & Medicaid Services Competitive Bidding Program: Assessment of Impact on Beneficiary Acquisition of Diabetes -Testing Supplies and Durable Medical Equipment, Prosthetics, Orthotics and Supplies-Associated Health Outcomes” may be found here. Below is an excerpt.

• Regardless of CMS’s motives and rationale for their inadequate monitoring program, findings from Puckrein et al. clearly show a significant disruption in acquisition of diabetes-testing supplies among beneficiaries who require these products for the safe and effective management of their disease. This disruption prompted a large percentage of beneficiaries to reduce or cease acquisition of diabetes-testing supplies. This behavior that was linked to increased mortality, hospitalizations, and associated costs.