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Rural Health
News by Topic: Healthcare business and finance

Public Inspection: CMS: Medicare Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs Federal Register
Dec 13, 2017 - Republication of a final rule from the Centers for Medicare and Medicaid Services (CMS) revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) Payment System for calendar year 2018. Included in the rule is a provision that reduces Medicare Part B payments to Disproportionate Share Hospitals (DSHs) and Rural Referral Centers (RRCs) for drugs acquired through the 340B Drug Pricing Program. Effective January 1, 2018, payments to affected facilities will be reduced from average sales price (ASP) plus 6 percent, to ASP minus 22.5 percent. Among others, Critical Access Hospitals (CAHs) and rural Sole Community Hospitals (SCHs) are excluded from this payment adjustment. Comments regarding provisions of the rule must be submitted no later than 5:00 p.m. Eastern on December 31, 2017.
Source: Federal Register
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A Conversation with Roger Knak
Dec 12, 2017 - Radio interview with Roger Knak, the CEO of Fairview Regional Medical Center, a Critical Access Hospital in Oklahoma. Discussion includes the work the hospital has done to address patient satisfaction and community health needs and the importance of rural health infrastructure, among other things.
Source: Rural Health Leadership Radio
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CMS Office of the Actuary Releases 2016 National Health Expenditures
Dec 6, 2017 - The Centers for Medicare and Medicaid Services (CMS) Office of the Actuary has released a study on overall national health spending. The study includes spending growth trends for private health insurance, Medicare, Medicaid, prescription drugs, and out-of-pocket consumer costs.
Source: Centers for Medicare and Medicaid Services
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CMS: Medicare Program; Cancellation of Advancing Care Coordination Through Episode Payment and Cardiac Rehabilitation Incentive Payment Models; Changes to Comprehensive Care for Joint Replacement Payment Model: Extreme and Uncontrollable Circumstances Policy for the Comprehensive Care for Joint Replacement Payment Model Federal Register
Dec 1, 2017 - Final rule from the Centers for Medicare and Medicaid Services (CMS) cancelling the Episode Payment Models (EPMs) and Cardiac Rehabilitation (CR) Incentive Payment Model. The rule also finalizes revisions to the Comprehensive Care for Joint Replacement (CJR) Model, making participation in CJR voluntary for all low-volume and rural hospitals, regardless of geographic location. Additionally, the included interim final rule provides flexibility when determining episode costs for providers located in areas affected by extreme circumstances, such as hurricanes, in 2017. Comments regarding provisions of the interim final rule must be submitted no later than 5:00 p.m. Eastern on January 30, 2018. Additional information is available on the November 30, 2017, CMS fact sheet.
Source: Federal Register
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Rural Hospitals Balk as Insurers Narrow Coverage Sites
Dec 1, 2017 - Focuses on a specific Critical Access Hospital in Indiana to highlight the impact of a change in health insurance policy. Some health insurers no longer pay for outpatient MRI and CT scans unless they are done in free-standing imaging centers, which are typically less expensive. However, because hospitals have to have their imaging machines available at all times for emergencies, sending patients elsewhere can significantly affect their bottom lines, especially for small and rural hospitals. Additionally, this rule may force patients to travel further for care. (May require registration for full article.)
Source: Modern Healthcare
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CMS Finalizes Changes to the Comprehensive Care for Joint Replacement Model, Cancels Episode Payment Models and Cardiac Rehabilitation Incentive Payment Model
Nov 30, 2017 - The Centers for Medicare and Medicaid Services (CMS) implemented changes to the Comprehensive Care for Joint Replacement (CJR) Model. CMS also finalized the cancellation of the mandatory hip fracture and cardiac bundled payment models that were to be operated by the CMS Innovation Center. A fact sheet is available.
Source: Centers for Medicare and Medicaid Services
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CMS Releases Its Measures Under Consideration List for 2018 Pre-Rulemaking
Nov 30, 2017 - Blog post from the Centers for Medicare and Medicaid Services (CMS) announcing that they have released the annual list of quality and cost measures that are under consideration for Medicare quality reporting and value-based purchasing programs. CMS collaborates with the National Quality Forum (NQF) to get input from stakeholders on this list in order to provide more high quality care and achieve better individual outcomes.
Source: Centers for Medicare & Medicaid Services Blog
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Updated Medicare Part D Opioid Drug Mapping Tool Unveiled
Nov 29, 2017 - The Centers for Medicare and Medicaid Services (CMS) released an updated version of their interactive Medicare opioid prescribing mapping tool. This tool provides geographic comparisons of Medicare Part D opioid prescribing rates and includes county-level hot spots and outliers.
Source: Centers for Medicare and Medicaid Services
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CMS: Medicare Program; Contract Year 2019 Policy and Technical Changes to the Medicare Advantage, Medicare Cost Plan, Medicare Fee-for-Service, the Medicare Prescription Drug Benefit Programs, and the PACE Program Federal Register
Nov 28, 2017 - Proposed rule from the Centers for Medicare and Medicaid Services (CMS) that would revise Medicare Advantage (Part C) and Prescription Drug Benefit (Part D) regulations to implement certain provisions contained in the Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Act. The proposed rule also clarifies the "any willing pharmacy" requirement, which may work to support independent community pharmacies often found in rural areas, and improve rural beneficiaries' access to specialty drugs. Comments regarding provisions of the rule must be submitted no later than 5:00 p.m. Eastern on January 16, 2018. Additional information is available on the November 16, 2017, CMS fact sheet.
Source: Federal Register
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Amid Rural Hospital Crisis, One Georgia Hospital Thrives
Nov 27, 2017 - Highlights the successes of a rural Georgia hospital that was close to closure ten years ago. Recognizing their perilous position, the hospital gambled by investing in more programs rather than cutting back. Their nursing home began a ventilator care program. The hospital invested in specialized equipment and staff, opened a pharmacy, worked to offer more services to reduce emergency room visits, and used social workers to help uninsured, disabled, and homeless patients find insurance coverage.
Source: 90.1 FM WABE
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