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Health Care Paradox: Medicare Penalizes Dozens of Hospitals It Also Gives Five Stars

KHN

The penalties — a 1% reduction in Medicare payments over 12 months — are based on the experiences of Medicare patients discharged from the hospital between July 2018 and the end of 2019, before the pandemic began in earnest. Paradoxically, all those hospitals have five stars, the best rating, on Medicare’s Care Compare website.

Medicare 136
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Health Care Paradox: Medicare Penalizes Dozens of Hospitals It Also Gives Five Stars

KHN

The penalties — a 1% reduction in Medicare payments over 12 months — are based on the experiences of Medicare patients discharged from the hospital between July 2018 and the end of 2019, before the pandemic began in earnest. Paradoxically, all those hospitals have five stars, the best rating, on Medicare’s Care Compare website.

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Discharge from Inpatient Facilities to Home-Based Settings for Medicaid Participants: Public Comment Framing Document

Briggs Healthcare

acute care hospital, long-term acute care hospital [LTAC], skilled nursing facility [SNF], inpatient rehabilitation facility [IRF]) to their home (e.g., acute care hospital, long-term acute care hospital [LTAC], skilled nursing facility [SNF], inpatient rehabilitation facility [IRF]) to their home (e.g.,

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National Care Coordination Standards for Children and Youth with Special Health Care Needs (CYSHCN): Proceedings from the National Forum on Care Coordination for CYSHCN

NASHP

Federal agencies have also prioritized and supported advancing integrated care. For example, the Centers for Medicare & Medicaid Services Innovation Center is currently supporting the Integrated Care for Kids (InCK) model across seven sites in six states. Assessing existing strategies, capacity, and gaps.

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Behavioral Health System Modernization along the Continuum

NASHP

North Carolina’s comprehensive behavioral health approach included efforts to increase uptake of CoCM through additional training and practice supports and Medicaid rate increases to 120% of Medicare rates for behavioral health providers. An action plan dashboard tracks targets. CMS’s Birth to 5: Watch Me Thrive!

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CMS Promotes Competition, Transparency, Health Equity and More in the CY2025 Medicare Advantage and Part D Proposed Rule

Sheppard Health Law

On November 6, 2023, the Centers for Medicare and Medicaid Services (“CMS”) released the contract year 2025 proposed rule for Medicare Advantage (“MA”) organizations and Part D sponsors (the “Proposed Rule”). The UM committee was established in April 2023 in the 2024 Medicare Advantage and Part D Final Rule (CMS-4201-F).