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The 340B Drug Pricing Program
For more than 30 years, the 340B Drug Pricing Program has provided financial help to hospitals serving vulnerable communities to manage rising prescription drug costs. Despite significant oversight from HRSA and the program’s proven record of decreasing government spending and expanding access to patient care, some want to scale it back or drastically reduce the benefits that eligible hospitals and their patients receive from the program.
Skilled Nursing Facility PPS
The Centers for Medicare & Medicaid Services (CMS) July 31 issued its fiscal year (FY) 2024 final rule for the skilled nursing facility (SNF) prospective payment system (PPS).
Inpatient Rehabilitation PPS
The Centers for Medicare & Medicaid Services (CMS) March 27 issued its fiscal year (FY) 2025 proposed rule for the inpatient rehabilitation facility (IRF) prospective payment system (PPS).
Long-Term Care Hospital PPS
The CMS on April 10 issued a proposed rule for the inpatient and long-term care hospital (LTCH) prospective payment systems (PPSs) for fiscal year (FY) 2025.
Rural Health Services
Some 61 million rural Americans depend on their hospital as an important source of care as well as a critical component of their area's economic and social fabric. Location, size, workforce, payment and access to capital challenge small or rural hospitals and the communities they serve. Collaborating with state and regional hospital associations and with advice from its member council, the Section tracks the issues, develops policies and identifies solutions to our most pressing problems.
Navigating Value-based Payment
In the 14 years since passage of the Affordable Care Act (ACA) and 9 years since the passage of the Medicare Access and CHIP Reauthorization Act (MACRA), there have been numerous programs developed by Medicare, states and commercial payers to support the movement to outcomes or value-based reimbursement.
Capitated and Global Budget Models
At the upstream end of the value-based payment spectrum, organizations can assume full risk for a population through capitated payments, global budgets, and provider led insurance plans.
Current and Emerging Payment Models
Health care is currently in the middle of a transition from a system of payment based on the volume of services provided (fee-for-service) to payment based on the value of those services (value-based care and alternative payment models).
Accountable Care Organizations
What are Accountable Care Organizations? What are ACOs? An ACO is a group of clinicians, hospitals and other health care providers who come together voluntarily to give coordinated high-quality care a designated group of patients.
Rehabilitation Services
Rehabilitation services are measures taken to promote optimum attainable levels of physical, cognitive, emotional, psychological, social, and economic usefulness, and thereafter to maintain the individual at the maximal functional level.