Senate bill would let Medicare test telehealth expansion

From Modern Healthcare:

A bipartisan bill introduced in the Senate last week would let Medicare experiment with covering more telehealth services.

Under the Telehealth Innovation and Improvement Act, sponsored by Sen. Cory Gardner (R-Col.) and Sen. Gary Peters (D-Mich.), selected hospitals would be allowed to test offering telehealth services to Medicare beneficiaries in cooperation with the Center for Medicare and Medicaid Innovation.

CMS wants to make accrediting organization surveys public

From Becker’s:

CMS may require national accrediting organizations to make provider and supplier survey reports and plans of corrections available online.

Right now, accrediting bodies like the Joint Commission do not make their survey findings publicly available, but CMS does.

The agency included the proposal in its 2018 Medicare Inpatient Prospective Payment System proposed rule released Friday.

“Access to survey reports and PoCs will enable healthcare consumers, in addition to Medicare beneficiaries, to make a more informed decision regarding where to receive healthcare thus encouraging healthcare providers to improve the quality of care and services they provide,” according to CMS’ fact sheet on its IPPS proposed rule.

Developmental, behavioral issues more common among rural children

From Healio:

Rural children from small communities exhibited a higher prevalence of mental, behavioral and developmental disorders than children living in cities and suburbs, according to data from the CDC’s Morbidity and Mortality Weekly Report.

“Indicators of poor mental health among adults — for example, serious mental illness among men, major depressive episodes among men and women, and recent serious psychological distress among women — have been found to be higher in large rural counties than in small, rural, suburban and urban counties,” Lara R. Robinson, PhD, from the National Center on Birth Defects and Developmental Disabilities at the CDC, and colleagues wrote. “Most studies examining children’s mental health in rural and urban areas indicate comparable rates of mental disorders in the two types of areas. However, mental disorders might be underreported in rural areas.”

Sen. Claire McCaskill of Missouri calls for GAO report on closings of rural hospitals

From the Star:

Sen. Claire McCaskill, a Democrat, has called on two federal agencies for more details about support of hospitals and schools in sparsely populated areas.

The Missouri senator wrote to the Government Accountability Office seeking answers to several questions about the rate at which rural hospitals are closing, what’s driving those trends and what it means for the quality of health care in those areas. The GAO is the investigative arm of Congress.

NRHA Applauds Introduction of Rural Hospital Access Act of 2017

From the NRHA:

The National Rural Health Association (NRHA) applauds Sens. Chuck Grassley (R-IA) and Chuck Schumer (D-NY) and Reps.Tom Reed (R-NY) and Peter Welch (D-VT) for introducing the Rural Hospital Access Act of 2017 (S. 872, H.R. 1955). This important bipartisan bill will improve access to care in rural areas by permanently addressing the Medicare Dependent Hospital and Low Volume Adjustment rural Medicare programs that expire October 1, 2017.

This legislation is essential to preserving continued access and keeping rural hospital doors open in rural America. The MDH and LVH programs for hospitals and providers are not ‘bonus’ or ‘special’ payments, but rather alternative, cost-effective and targeted payment formulas that maintain access to care for millions of rural patients and financial stability for thousands of rural providers across the country.

MDHs and LVHs play a critical role in rural communities, providing not only vital medical care but also as one of the largest employers within their community. Without these programs, rural patients would be forced to travel farther for more expensive care. Or worse, these rural Americans would forego essential care because they could not reach the necessary medical providers, resulting in poorer health, a lower quality of life, and more expensive care later.

NRHA encourages members of Congress to cosponsor the Rural Hospital Access Act.

How Is An Emergency Room Like A Monkey Wrench?

From Investor’s Business Daily:

Which of the following is true: Emergency rooms are the most expensive venues for primary care — or ERs are the least expensive venues for primary care? Arguably, both answers are correct, providing a powerful example of why health care finance and resource allocation in America are so irrational.

Recall that the U.S. military allegedly paid $2,228 for a monkey wrench around 1980 (roughly $6,600 in 2017 dollars). In contrast, you can buy monkey wrenches at Wal-Mart today for between $5 and $30. So, depending on who writes the check, a monkey wrench can be either the most expensive or least expensive tool in your shed.

Rural hospitals tend to use more skilled nursing facility versus home health care services, leading to higher healthcare costs

From RevCycleIntelligence:

Despite receiving similar post-acute care services overall, rural hospital patients tend to undergo more skilled nursing facility treatment than home health care versus urban hospital patients, contributing to higher healthcare costs, according to recent research in the American Journal of Accountable Care.

With increased skilled nursing facility use, healthcare costs rise. The average cost of a skilled nursing facility stay is $11,357 versus just $2,720 for a home health care episode, the study stated, citing a March 2015 Medicare Payment Advisory Commission (MedPAC) report.

Colorado-based researchers examined the 2012 National Inpatient Sample from the Health Care Cost and Utilization Project to determine how post-acute care utilization and Medicare spending varies by geographic region.

The data revealed that post-acute care utilization was similar among patients discharged from rural versus urban hospitals. Rural hospital patients were only slightly less likely to receive post-acute care with an odds ratio of 0.95.