Trump Admin Strikes Deal With 42 States On Improving Medicaid Quality
The Trump administration has announced that 42 states will partners with the Centers for Medicare & Medicaid Services to rethink how quality is measured in Medicaid and the children’s health program (CHIP). CMS said the partnership will put health outcomes “at the center of how success is defined” and streamline hundreds of reporting requirements.
The initial state participants have about 56 million Medicaid and CHIP beneficiaries and account for roughly $701 billion in fiscal 2024 Medicaid spending. At the center will be streamlining quality measure inventories, adopting digital quality measurement with near-real-time data when possible, and aligning financial accountability with outcomes measures.
The program lines up incredibly well with efforts to boost lagging Medicaid outcome performance, interoperability, as well as migrate all government programs to a universal foundation of measures.
Additional articles: https://www.fiercehealthcare.com/regulatory/37-states-partner-cms-initiative-rethink-medicaid-quality-measures and https://www.cms.gov/newsroom/press-releases/cms-refocuses-medicaid-quality-health-outcomes-launches-innovative-partnership-37-states
#quality #medicaid #cms
Less Charity Care By 340B Hospitals
A new report from the Pioneer Institute and CancerCare finds that 340B hospitals are providing less charity care than other nonprofit hospitals, despite receiving deep discounts in the program. Hospitals in 340B spent 2.16% of their operating expenses on free or discounted care for low-income patients, while those not in the program spent 2.82%. The 340B discounts are between 25% and 50% on drug purchases, without the absolute requirement to pass on savings to patients.
Pioneer said 340B hospitals spend less on charity care for uninsured patients. Spending represented 1.6% of operating expenses at 340B hospitals, versus 2.26% at non-340B hospitals, according to the report. 340B hospitals of course disagree, but other studies show that pricing for drugs to patients at such facilities are actually higher than other facilities that do not receive the discounts. The program has exploded over time and needs to be reined in. The administration is attempting to do so, but Congress has yet to pass reforms.
#340b #drugpricing #healthcare #hospitals
House Dems Reveal Healthcare Agenda
House Democrats have drafted a mammoth healthcare reform bill that includes:
- Reversing the Medicaid cuts enacted under the One Big Beautiful Bill Act (OBBBA), which could mean millions lose coverage.
- Reinstating the enhanced Exchange premium tax credits that expired. Millions have lost coverage on the Exchanges.
- Pursuing universal coverage, with large expansions of the Medicare and Medicaid programs. It does not endorse a Medicare for All program.
- Reining in corporate monopolies and regulating large healthcare companies.
- Limiting Americans’ total healthcare costs to 8% of income.
#healthcare #healthcarereform #midterms
ECDS Looming For Health Plans
A good Health Affairs Forefront article discusses the looming retirement of hybrid measurement and the introduction of electronic data requirements in quality measurement.
#quality #medicare #medicaid #ncqa
— Marc S. Ryan
