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What We're Reading: Hospice Payment Increase; Overdose Death Rates; Price Transparency Lawsuit
Hospices will receive a $520 million increase in payments from CMS in fiscal year 2020; urban areas accounted for more drug overdose deaths rates than rural areas in 2016 and 2017; a federal judge has ruled that a lawsuit against a California price transparency law can proceed.
Hospices to Get Boost in Medicare Payments
Under a final rule issued by CMS, hospices will see a $520 million (2.5%) increase in their payment rates for fiscal year (FY) 2020. According to CMS, the boost is based on the FY 2020 hospital market basket increase of 3% reduced by the multifactor productivity adjustment of 0.4%. The increase is smaller than the $540 million (2.7%) increase that was proposed in April. For hospices that fail to meet quality metrics, they will receive a 2% reduction to the annual market basket update for the year. The final rule will also cap the amount of overall payments per patient made to a hospice annually at $29,964.78.
Urban Areas Now See More Overdose Death Rates
Data from the CDC have revealed that urban areas now see more drug overdose deaths rates than rural areas. In 2016 and 2017, the overall drug overdose death rate was 22.0 per 100,000 in urban counties compared with 20.0 per 100,000 in rural counties. Overdose death rates in urban areas surpassed the rates seen in rural areas for overdose deaths involving heroin (5.2 vs 2.9), synthetic opioids other than methadone (9.3 vs 7.0), and cocaine (4.6 vs 2.4). The data also put a spotlight on gender differences, with men having drug overdose rates that were higher in urban counties and women having overdose death rates that were higher in rural counties.
Judge Allows Lawsuit Over California Price Transparency Law
Two years ago, California implemented a law that requiring drug makers to notify insurers and government health insurers at least 60 days before increasing the list price of any drug that costs more than $40 by at least 16% in a 2-year period. This week, a federal judge ruled that the Pharmaceutical Research and Manufacturers of America, the pharmaceutical industry's leading lobby group, could proceed with its amended lawsuit alleging that the law is unconstitutional because it violates interstate commerce and free speech principles, unfairly holds drug makers responsible for prices, and purposely has fuzzy language about the time frame for notice of a price hike, reported STAT News.
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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New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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