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CMS has rescinded the controversial two-midnight rule's cuts to inpatient reimbursement and will give hospitals a 0.6 percent payment increase in 2017 to offset reductions in 2014-2016, Modern Healthcare reports. The change was included in the FY 2017 Medicare Inpatient Prospective Payment System proposed rule. The 1,579-page rule covers much more, including proposed rates for long-term care hospitals. Overall, the proposed rule would apply to about 3,330 acute care hospitals and 430 long-term care hospitals for discharges occurring on or after Oct. 1. (Modern Healthcare; Becker's Hospital CFO; proposed rule)
 
Improving communication, making sure patients are truly ready to be discharged and providing better post-discharge resources could significantly reduce hospital readmissions, according to a recent study published in JAMA Internal Medicine. Such efforts could have prevented readmissions in 27 percent of cases. Furthermore, 52 percent of those preventable readmissions could have been avoided "with efforts made during the initial admission," the study says. (HealthLeaders Media; JAMA Internal Medicine)


United Healthcare announced Tuesday that, in 2017, it's pulling out of all but a handful of its 34 exchanges. Compared to Aetna or Anthem, only a small portion of United's revenue comes from the exchanges. Nevertheless, were United to abandon the exchanges completely, more than 1 million consumers would be left with a single health plan option, according to a Kaiser Family Foundation analysis released Monday. The greatest impact would be in states in the South and Midwest. (Washington Post; KFF analysis)

Innovation & Transformation 
Geisinger Health System has followed through on its promise to refund money to unhappy patients. The system is the country's first to adopt a policy of issuing customer refunds. David Feinberg, CEO and president, suggested the idea. "We want to make sure we not only have the right care that is high quality and safe, but we also want to make sure our care is compassionate, dignified and delivered with a lot of kindness," he says. Geisinger received 74 requests between October and mid-March and refunded or waived charges of nearly $80,000. Only co-payments and deductibles are eligible. (Washington Post)
 
In his Modern Healthcare editorial last week, Merrill Goozner calls out those skeptical of CPC+, CMS' expansion of its comprehensive primary care initiative. "Even if the program doesn't save money, it's the right thing to do for patients and the healthcare system," he says, calling it a "bold move." Rank-and-file primary-care physicians need significant financial incentives to coordinate care. "Only primary-care docs, when given time to develop solid ties with patients and local communities, can deliver better health outcomes through prevention and lifestyle intervention." (Modern Healthcare)
 
Consumers & Providers
Florida is expanding its prescribing authority to allow nurse practitioners and physician assistants to prescribe controlled substances. It's well behind the curve. According to the American Association of Nurse Practitioners, Florida was the lone state barring NPs from prescribing any controlled substance. According to the American Academy of Physician Assistants, Florida was almost the last holdout on PAs: Today, only Kentucky forbids PAs to prescribe controlled substances. (Healthcare Dive)
 
 
Despite national guidelines urging emergency department doctors to ask suicidal patients if they have access to firearms or other lethal implements, only about half actually do, according to a study published in Depression and Anxiety. "Multiple ED visits appear to be a risk factor for suicide and many suicide victims are seen in the ED shortly before death," according to the researchers, who estimate that ED-based interventions might help decrease suicide deaths by 20 percent annually. (Depression and Anxiety; announcement)
 
 
Consumers are opting to save money on health insurance by turning to short-term policies. Rather than choosing HIX options, they're doing the math of the premium, tax penalty, loss of subsidies and the risks of a shorrt-term policy (e.g., no guaranteed renewal). Because the plans don't qualify as individual coverage under the ACA, they trigger the tax penalty. Even so, the plans represent a savings for many consumers. "Ultimately, this is about affordability," says Nate Purpura, vice president of consumer affairs at eHealth. "People have to make financial decisions about what they can afford every month." (CBS News)
 
 
The first full year of the Affordable Care Act brought historic increases in coverage for low-wage workers and others previously excluded from the health care system, a New York Times analysis found. Part-time workers gained insurance at a higher rate than full-time workers, and people with high school degrees gained it at double the rate of college graduates. Immigrants had the sharpest rise in coverage rates. "From the vantage point of the poor and working poor, Obamacare has been profound," said Jim Mangia, president of the St. John's Well Child and Family Center, an FQHC in South Los Angeles. (The New York Times)
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New & Noted   
A new breed of consultant: Consultants are guiding families through the myriad addiction treatment options to help loved ones return to a functional, successful life. But the services can be costly, and the health care professionals at the treatment facilities don't always appreciate the consultants. (The New York Times)

A sign of trouble? Don't believe those emergency department billboards. What constitutes "wait time" varies, and some experts warn that promoting wait times may encourage patients to "self-triage" and drive longer distances to avoid a perceived wait. Healthcare Dive explores the issue. (Healthcare Dive) 
 
Hospitals need data: Hospitals need historical Medicare data to successfully move into bundled payment models, Vinita Bahl, DMD, MPP, writes in a Health Affairs Blog post. "CMS is moving quickly to adopt bundled payments, but should move just as quickly to deliver a health care data infrastructure to help hospitals succeed." (Health Affairs Blog)

Multi-media 
Six days after Regina Holliday's husband died, she started painting a mural on the side of a gas station, off a busy street in Washington, D.C. That was the start of her lifelong pursuit of improving patient access to health information. (The Pulse)
 
MarketVoices...quotes worth reading
     
"It's sort of like a slap in the face. After all that you've done, after the $60,000 it cost to be in this hospital, you're going to charge me 73 cents per page, just to see info we've already paid for?" -- Regina Holliday on being charged for copies of her husband's medical records (The Pulse)    
   
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Wednesday, April 20, 2016