Top Healthcare Quality Issues for 2015, Part 1

Cheryl Clark, January 6, 2015

His members, primarily safety net hospitals, "face disproportionate penalties in these programs," whose penalties create a "vicious circle that actually threatens quality by reducing scarce resources at these hospitals," he said in an e-mail response.

4. Demise of the Partnership for Patients

The Obama administration has proudly credited Partnership for Patients programs such as the 26 Hospital Engagement Networks and the Community-Based Care Transitions Program, enabled by $800 million in federal funds since 2011, for improving hospital care.

But funding for the HEN programs ran out Dec. 31, 2014, and the CBCT money ends in 2015, leaving hospitals clueless about what worked and what didn't.

Many healthcare leaders will watch closely to see if those programs instilled permanent cultural changes to maintain the improvements, or whether the reductions in adverse events are the result of more careful clinical documentation.

5. Medicaid parity expiration hurts doctor supply

Expansion of Medicaid in all states was one goal of PPACA, which allows financial enticements to enlist more primary care physicians to accept Medicaid patients, hopefully speeding access to care.

To accomplish that, Congress set aside $12 billion to subsidize Medicaid payments for primary care providers and pediatricians up to Medicare levels for two years. A December Urban Institute study estimated that the "fee bump" increased Medicaid payments by 73% on average.
The bump came just in time too, because 7.5 million Medicaid enrollees have been added in 27 states and the District of Columbia since the third quarter of 2013, the report says.

But that subsidy expired Dec. 31, 2014, plummeting Medicaid payment rates back to their former state-set levels. And while 15 states will continue the fee increase with state funds, 24 won't and the rest remain undecided. It's important to note that 71.3% of the nation's 68 million Medicaid enrollees reside in those 24 states that won't continue the increase, including the biggest: California, New York, New Jersey, Florida, and Pennsylvania.

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