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SGR Bill Would Extend Delay of 'Two-Midnights' Policy
The House Ways and Means bill to temporarily prevent Medicare physician payment cuts also would deliver an Easter gift to hospitals-a six-month extension to comply with a controversial new inpatient payment rule for hospitals.
The House Ways and Means bill to temporarily prevent Medicare physician payment cuts also would deliver an Easter gift to hospitals—a six-month extension to comply with a controversial new inpatient payment rule for hospitals.
The existing “two-midnights” rule says admitting physicians must have good reason to believe that a patient will need two nights in the hospital before Medicare will pay full inpatient rates under Part A for the stay. Lacking such documentation, Medicare auditors will generally classify the stay as outpatient observation, which pays hospitals much less under Part B and sticks the patient with a 20% copayment. That rule went into effect Oct. 1. But it was modified so that Medicare's aggressive recovery auditing companies could not overturn claims under the new policy until Sept. 30, 2014.
Read the full story here: http://bit.ly/1hwOUIi
Source: Modern Healthcare
Hospital Participation in Medicare ACOs: No Change in Admission Practices and Spending
August 19th 2025Hospital accountable care organization (ACO) participation did not impact emergency department admission rates, length of stay, or costs, suggesting limited effectiveness in reducing spending for unplanned admissions and challenging hospital-led ACO cost-saving strategies.
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Laundromats as a New Frontier in Community Health, Medicaid Outreach
May 29th 2025Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.
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Care Quality Metrics in Medicare During COVID-19 Pandemic
August 12th 2025Medicare Advantage outperformed traditional Medicare on clinical quality measures before and during the COVID-19 pandemic; mid-pandemic, however, traditional Medicare narrowed the gap on some in-person screenings.
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