Nursing Home Star Ratings Likely To Fall Under New System
Starting immediately, the federal government is making it harder for nursing homes to get four- or five-star grades on the national website Nursing Home Compare, raising the bar on an array of quality measures. The administration also announced plans to move toward value-based oncology payments to address the spiraling costs of cancer care.
The New York Times:
Government Will Change How It Rates Nursing Homes
Under the changes, scores are likely to fall for many homes, federal officials said, although they did not provide specific numbers. Facilities will see a preview of their new scores on Friday, but the information will not be made public until Feb. 20. (Thomas, 2/12)
Kaiser Health News:
Government To Grade Nursing Homes On Tougher Scale
Starting immediately, the federal government is making it harder for nursing homes to get top grades on a public report card, in part by increasing scrutiny of their use of anti-psychotic drugs and raising the bar on an array of quality measures. Those grades – in the form of one- to five-star ratings – are part of Nursing Home Compare, a government website to help consumers evaluate nursing homes. While the star ratings, which debuted in December 2008, are lauded as an important tool, critics say they rely too heavily on self-reported data and allow a majority of homes to score high ratings. (Appleby, 2/12)
The Hill:
Obama Administration Moves To Reform Cancer Care Payment System
The Department of Health and Human Services (HHS) announced plans Thursday to better take quality of care into account — rather than just the quantity of services offered — when it comes to payments for cancer treatments. The new Oncology Care Model announced Thursday provides performance-based payments for chemotherapy under Medicare in order to incentivize high-quality care. It is part of a larger effort by HHS to transition away from the dominant fee-for-service model toward one that pays based on performance and whole episodes of care, rather than for each procedure. (Sullivan, 2/12)
Modern Healthcare:
Medicare Moves Toward Value-Based Oncology Payments
The CMS Innovation Center plans to test a new oncology payment model intended to address the spiraling costs of cancer care and improve quality for beneficiaries. As part of a broader federal push to reward hospitals and doctors for value rather than the volume of services they provide, the CMS is inviting oncology practices and solo practitioners to join a five-year test set to begin in the spring of 2016. Private payers and oncology groups have already experimented with similar cancer-specific payment models. Though members of those groups commended the CMS for the initiative, they also expressed disappointment that it doesn't make a clean break from fee-for-service payments. (Rice, 2/12)
Meanwhile, a Florida fraud prosecution shines a light on Medicare Advantage plans -
Center for Public Integrity:
Fraud Case Puts Spotlight On Medicare Advantage Plans
As the Medicare Advantage industry scrambles to stave off proposed government funding cuts, federal prosecutors in Florida are pursuing an unusual criminal fraud case that’s likely to raise new concerns that some of the health plans for seniors may be overcharging for their services. The criminal case, believed to be among the first to take aim at Medicare Advantage billing tactics, centers on a South Florida doctor affiliated with Humana Inc., one of the biggest players offering the privately run Medicare Advantage plans. (Schulte, 2/13)
And Iowans are counseled to ask prospective presidential candidates about their Medicare plans -
Des Moines Register:
Ask Candidates About Medicare Costs, Iowans Urged
Iowans should ask presidential candidates how they would control health care costs so the nation’s budget deficit doesn’t continue to mushroom, two national experts said Thursday in Des Moines. Too often, any candidates who make serious proposals to reform Medicare are hit with ads showing they intend to throw grandmothers off cliffs, said Doug Holtz-Eakin, president of the American Action Forum. (Leys, 2/12)