Monday Morning Medicaid Must Reads: October 22nd, 2018

Helping you consider differing viewpoints. Before it’s illegal. 


Article 1:  

AHCA Points to Gains in Quality as House Panel Weighs SNF Oversight, Patrick Connole, Provider Magazine, 9/5/2018

Clay’s summary: Big Nursing Home lobby cries Uncle; asks for less regulation, please.

Key Passage from the Article

Ahead of a congressional hearing to scrutinize federal oversight of skilled nursing care, the American Health Care Association (AHCA) on Sept. 5 urged lawmakers to recognize the steady and significant improvement in the quality of care for skilled nursing care center residents instead of considering more regulation of an “already overburdened sector.” 

The statement by Mark Parkinson, president and chief executive officer of AHCA, came before a House Energy and Commerce Subcommittee on Oversight and Investigations hearing titled “Examining Federal Efforts to Ensure Quality of Care and Resident Safety in Nursing Homes.”

He said while the discussion agenda is focused on whether the Centers for Medicare & Medicaid Services (CMS) and Office of Inspector General exercise enough oversight to ensure residents are free from abuse and receive proper care, such a debate is missing the point and continues a pattern of disrespecting the nursing care profession.

“At a time when Congress faces public criticism for its failure to work together and accomplish shared goals, this hearing seems like a misguided effort to find more ways to regulate an already overburdened sector,” Parkinson said. Long term care is one of the most regulated industries in the country, “yet we’ve shown some of the most dramatic improvement on both self-reported and government quality measures.”


Read it here 

Article 2:   

Quality Improvement Projects Save Children’s Hospitals Millions, Jacqueline LaPointe, RevCycle Intelligence, 6/21/2018

Clay’s summary: Better management of asthma in pediatric populations can pay off. So can avoiding medical errors.

Key Passage from the Article

With their drive to deliver high-value care in mind, Nationwide Children’s Hospital in Ohio and Yale New Haven Children’s Hospital in Connecticut embarked on quality improvements efforts to address specific issues within their organizations that were impacting patient outcomes and cost.

Their quality improvement projects paid off in more ways than one. Nationwide has reported significant improvements in asthma control, resulting in $5.2 million in savings, while Yale New Haven Children’s Hospital has seen patient safety and error reporting increase, catching $3 million in savings for the hospital.


Read it here 




Article 3:   

CMS Awards $5.5M to Develop Palliative Care Quality Measures, Kaitlyn Mattson, Home Health Care News, 9/30/2018

Clay’s summary: Efforts to bring palliative care into value-based care are in the early stages.

Key Passage from the Article

The American Academy of Hospice and Palliative Medicine (AAHPM), in partnership with the National Coalition for Hospice and Palliative Care and the RAND Corporation, has been awarded a three-year $5.5 million grant from Centers for Medicare & Medicaid Services (CMS) to develop patient-reported quality measures for community-based palliative care.

Filling the gaps in quality measurement of palliative care is one of the main sticking points for the three-year grant, according to AAHPM.

One of the many reasons to develop measures is because major gaps were observed in quality measurement for people with serious illness, according to a 2015 report measuring quality indictors for hospice and palliative carefrom AAHPM and the Hospice and Palliative Nurses Association.


Read it here