Posts in Policy & Research
Budget Impasse Causes Delay in NC’s Medicaid Transformation

On September 3, North Carolina Department of Health and Human Services Secretary, Mandy Cohen, announced that implementation of the state’s Medicaid Transformation would be delayed. Phase One was originally scheduled to go-live on November 1, 2019 with the enrollment of Region 2 and 4 beneficiaries into managed care. While Open Enrollment will be extended for beneficiaries in these regions, managed care will now begin for all regions, statewide, on February 1, 2020.

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Policy & ResearchSarah Dohl
Stakeholders Provide Feedback to Changes in CMS Hospital Star Ratings

On August 19, the Centers for Medicare and Medicaid Services (CMS) announced its plans to change the controversial methodology used for its hospital star ratings on Hospital Compare. However, changes won’t occur until 2021. At that time, CMS will “refresh” the star ratings on Hospital Compare using current methodology in order to ensure that patients continue to have timely access to the most up-to-date hospital quality information. The press release about this change highlights the initiative as a major step forward in delivering on President Trump’s recent Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First, which seeks “to enhance the ability of patients to choose the healthcare that is best for them.”

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CMS Releases State Guidance for Medicaid Implementation of SUPPORT Act

States must amend their State Plan and receive CMS approval of the application for implementation of these DUR requirements. State Plan amendments must be submitted no later than December 31, 2019 with an October 1, 2019 start date. Amendments must include sufficient detail describing how the state either currently supports or is implementing and providing oversight for each of the four new requirements under the SUPPORT Act. 

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FCC Seeks Comment on $100M Connected Care Pilot Program Approved in Support of Expanding Telehealth Adoption

This article summarizes some of the key programmatic elements that health care providers, associations, and other stakeholders are being asked to provide comment on by the FCC. While this targeted Pilot may not align with the population that a provider or organization typically serves, it is important for all stakeholders to understand that how the FCC defines terms and programmatic policy may impact how other Federal agencies, and potentially states, develop programs and policies related to telemedicine and telehealth. A consistent and integrated approach to state and federal law and policy that benefits all parties will ultimately reduce administrative burden, improve adoption, and increase efficiencies across all telehealth programs.

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Ensuring Compliance and Success with Nonprofit Hospital Community Benefits Reporting

There is a renewed interest at the federal level in ensuring that tax-exempt hospitals are meeting the intent of the community benefits standard. Senator Chuck Grassley, chair of the Senate Finance Committee, was the impetus for changes to the tax code that instituted initial reporting requirements for tax-exempt hospitals back in 2008. Grassley has retaken his seat as the chair of the Committee and revived his oversight of this issue last month with a letter to IRS Commissioner Charles Rettig, asking for a briefing on the full scope of the agency’s audits. It is therefore critically important that tax-exempt hospitals and their staff understand and engage in the process to achieve compliance.

In this article, we provide information to educate hospital staff and leaders about these requirements by:

  • Defining community benefits

  • Explaining the purpose and process for the CHNA and CHIP, and

  • Advising hospital leadership on approaches to ensure that staff are regularly and accurately reporting qualifying activities

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Opportunities for Behavioral Health Transformation: Making Change

Over the past decade, public behavioral health systems across the country have undergone one transformation after another. As a result, providers and system stakeholders are often left feeling like just when one transformation finishes it’s time to start over again. As you can imagine, this continual state of transformation is difficult to manage. Why? Because transformation is change. And, in life, we know that even though change is a constant, it’s hard. To change the world, you have to change the way you see it. You have to change the way you operate in it. You have to change your approach.

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Policy & ResearchBrea Neri
Medicare Advantage: Seeing the Value in Addressing the Social Determinants of Health

Once a year, Medicare beneficiaries have the opportunity to renew their coverage or make changes to their Medicare enrollment. That can mean choosing to enroll in Medicare Advantage (MA), selecting a new MA plan, or opting for a different benefit package. This Annual Election Period is now in full swing—running from October 15th through December 7th. This year, in many locations, beneficiaries may have several new options to choose from, as existing MA plans are expanding their footprints to serve more states and counties. Plan choice will increase nearly 20% in 2019 according to the Centers for Medicare and Medicaid Services (CMS). Now, more than 91% of Medicare beneficiaries will have access to 10 or more MA plans compared to 86% in 2018.

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Policy & ResearchBrea Neri
Australian Commission on Safety and Quality in Health Care Publishes Report Developed by The Nous Group, Atromitos

The Australian Commission on Safety and Quality in Health Care has published a report developed by The Nous Group, in partnership with Atromitos, on the Review of Key Attributes of High-Performing Person-Centered Health Care Organizations. The report identifies attributes of person-centered care across all aspects of a health care organization, from leadership, people, and culture to governance, technology, and the way health care is delivered.

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