June 21, 2013
By Allison Cohen*
Edited by Amy Kaufman
MedPAC Reports that Medicare Readmissions Penalties Disproportionately Impact Hospitals that Serve Poor Patients
Voxxi (6/17) posted an article about the Medicare Payment Advisory Commission's (MedPAC) recent determination that Medicare readmissions penalties should be changed because they disproportionately hit hospitals serving low-income patients. MedPAC helped create the readmissions penalty program, calling for the policy in 2008. MedPAC's recent report agrees that there are shortcomings in the program and that in the future, Medicare should compare hospitals that care for similar numbers of poor patients when determining penalties.
ACGME's Next Accreditation Program Will Evaluate Residents for a Range of Competencies at Various Points in their Training
Modern Physician (6/17) reports that the Accreditation Council for Graduate Medical Education's (ACGME's) Next Accreditation System (NAS) will require institutions to determine how well residents at various benchmarks "can demonstrate competency in patient care, medical knowledge, practice-based learning and improvement, systems-based practice, professionalism, and interpersonal skills and communication" starting July 1. The ACGME will first roll out the NAS for programs involving emergency medicine, internal medicine, neurological surgery, orthopedic surgery, pediatrics, diagnostic radiology, and urology. Thereafter, the ACGME will roll out the NAS for 19 other specialties.
More Residency Programs are Needed to Avert Physician Shortage
The Times Tribune (6/17) reports that without more residency programs, increasing the number of medical students will not prevent an impending physician shortage. The lack of a sufficient number of residency slots has been a problem since the Balanced Budget Act (BBA) of 1997, which limited the number of residents that teaching hospitals can claim for Medicare reimbursement purposes. While the number of residency positions has increased by 28% since 1996, the number of applicants has increased 38% in that time period. Funding is a major obstacle in increasing the number of residency training programs. "The Training Tomorrow's Doctors' Today Act" (H.R. 1201) would help avert the physician shortage by helping hospitals fund additional residency slots. If passed, the Act would create 15,000 additional Medicare-supported residency positions nationwide.
Missed Deadlines in Setting Up Health Insurance Exchanges Raise Concerns
The Wall Street Journal (6/19) reports that the U.S. Government Accountability Office has concerns about exchanges opening smoothly this October, pointing out that government officials have missed several deadlines in setting them up. In particular, the small business exchanges have encountered a number of obstacles, including low levels of carrier interest in some states. President Barack Obama has said the exchanges will be operational in October 2013, and will offer coverage to take effect January 1, 2014, as scheduled. (Note: registration is required to access this article.)
*We would like to thank Allison Cohen, Esquire (Association of American Medical Colleges, Washington, DC), for providing this week's update. We would also like to thank Amy E. Kaufman, Esquire (Patton Boggs LLP, Washington, DC), for coordinating the weekly update.