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Directed payments through Medicaid managed care plans have avoided much of the confusion — even suspicion — that surrounds other supplemental support to providers. But as policy evolves, will the accountability and transparency built into this payment mechanism be sufficient in the long run?

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The administration's proposed rule, Nondiscrimination in Health and Health Education Programs or Activities, will worsen access to care and disparities for many of the nation's most vulnerable populations.

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Centering Healthcare Institute requests proposals for implementation awards to increase access to its CenteringParenting care model; second wave proposals are due May 31, and third wave proposals are due July 31.

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A new case study highlights association member NYC Health + Hospitals' partnership with LegalHealth to provide legal assistance to patients.

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In a May 17 Capitol Hill briefing, leaders from NYC Health + Hospitals, East Alabama Medical Center, and Eskenazi Health shared how disproportionate share hospital funding sustains their hospitals.

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Four essential hospitals were honored for their environmental sustainability practices and commitments to mitigate climate change.

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The new chair is Melanie Bella, head of partnerships and policy at Cityblock Health and former founding director of the Centers for Medicare & Medicaid Services' Medicare-Medicaid Coordination Office. The Government Accountability Office also appointed a new vice chair and two new members.

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The Senate last week passed a new version of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019. House and Senate panels continue work to address balance billing and drug pricing ahead of next week's recess.

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The guidance lists warning signs for which hospital staff should be aware, recommendations for active shooter responses, and suggested protective measures.

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A Commonwealth Fund report reviews 36 state Medicaid quality strategies for advancing primary care, a key factor in achieving a high-performing health system.

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Providers interested in the professional or global options under the new Primary Cares Initiative must submit a nonbinding letter of intent by Aug. 2.

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A bipartisan group of 300 House lawmakers sent a letter to leadership calling for a two-year delay of Medicaid disproportionate share hospital cuts. The House will vote on a legislative package to expedite the availability of generic drugs and protect parts of the Affordable Care Act.

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We applaud the letter’s organizers, Reps. Eliot Engel (D-NY) and Pete Olson (R-TX), and all their House colleagues for recognizing the severe threat posed by Medicaid disproportionate share hospital payment cuts and standing up for patients, communities, and hospitals.

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The new law requires the state to contract with one or more insurers to offer qualified health plans through its individual insurance marketplace beginning in 2021, as well as fund premium subsidies for people earning less than 500 percent of the federal poverty level.

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Decisions made at the state and federal levels regarding Medicaid expansion continue to evolve nearly a decade after passage of the Affordable Care Act.

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A federal judge found the Department of Health and Human Services’ Medicare outpatient payment cuts in 2019 to hospitals in the 340B Drug Pricing Program were unlawful, extending a similar decision regarding 2018 cuts. The case was sent back to the agency to determine the appropriate remedy.

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America’s 340B hospitals are pleased with the District Court’s decision and urge the Department of Health and Human Services to follow the judge’s directive to promptly resolve the harm caused by its unlawful cuts to Medicare reimbursement.

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The House this week will take up legislation to protect people with pre-existing conditions and help generic drug and biosimilar manufacturers bring their products to market. A House letter calling for a delay of Medicaid DSH payment cuts has 286 bipartisan signatures; the deadline to sign is May 8.

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In a new request for information, the agency seeks ideas for innovative programs and waiver concepts states could consider in developing Section 1332 waivers. The request follows October 2018 guidance aimed at increasing state flexibility.

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The Department of Justice and 18 Republican-led states filed legal briefs in Texas v. United States arguing to uphold a ruling that the Affordable Care Act is invalid. Oral arguments in the appellate court are scheduled for the week of June 8.

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A new proposed rule for Medicare’s Inpatient Prospective Payment System for fiscal year 2020 would increase net inpatient payment rates by 3.2 percent in addition to numerous other policy and payment changes.

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America’s Essential Hospitals and industry partners have officially closed the book on their successful lawsuit to force the Department of Health and Human Services to implement long-delayed rules on pharmaceutical manufacturer accountability in the 340B Drug Pricing Program.

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A House letter calling for a delay of Medicaid disproportionate share hospital payment cuts has 178 bipartisan signatures; the deadline to sign is May 3. A House committee holds the first congressional hearing on the Medicare for All Act.

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Revised guidance clarifies what constitutes a ligature risk and outlines a ligature risk extension process for deficient hospitals; comments are due June 17.

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In a letter to state Medicaid directors, the Centers for Medicare & Medicaid Services encouraged states to partner with the agency to test innovative approaches to better serve beneficiaries who are dually eligible for Medicare and Medicaid.

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The Centers for Medicare & Medicaid Services will accept applications for its second cohort of participants in the Bundled Payments for Care Improvement Advanced Model; second cohort participants will start model year three, beginning on Jan. 1, 2020.

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Essential hospital The MetroHealth System, in Cleveland, is helping other hospitals launch programs that link trauma survivors with recovery coaches and peer volunteers.

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This State Policy Snapshot summarizes the challenges of misaligned federal privacy policies and how varying state laws can complicate matters — or provide possible paths forward.

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The Primary Cares Initiative comprises five new voluntary payment model options under two paths. The new models build on the experience of the Medicare Shared Savings Program and Next Generation Accountable Care Organization model.

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A new proposed rule would increase inpatient operating payment rates by 3.2 percent and make other changes to Medicare payment and quality reporting policies. CMS is accepting comments on the proposed rule until June 24.

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The Office for Civil Rights updated its website with new guidance related to health information technology access rights under the Health Insurance Portability and Accountability Act. The guidance is particularly relevant given the push for increased patient access through third-party applications.

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Hospitals in the Inpatient Quality Reporting, Prospective Payment System–Exempt Cancer Hospital Quality Reporting, and Hospital Outpatient Quality Reporting programs can view their preview reports through May 21.

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The Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health Information Technology extended to June 3 the deadlines for commenting on two proposed rules related to interoperability, patient access to health information, and information blocking.

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A letter circulating in Congress calling for a delay of Medicaid disproportionate share hospital payment cuts has gained more than 110 bipartisan signatures. The president signed a Medicaid extenders package, which includes a provision identical to the Advancing Care for Exceptional (ACE) Kids Act.

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Reducing preventable readmissions, which often are related to behavioral health conditions, with appropriate and timely care is of paramount concern to the members of Premier and America’s Essential Hospitals.

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CMS finalized the Notice of Benefit and Payment Parameters for the Affordable Care Act’s health insurance marketplace and the annual letter to issuers offering plans on the federally facilitated marketplaces for plan years beginning on or after Jan. 1, 2020.

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Learn why cultural competency matters during emergencies, explore the potential consequences of being culturally incompetent, and gain resources to help build understanding.

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Hospitals with the greatest proportion of Medicare patients dually eligible for Medicaid had decreased readmissions penalties, according to a study in JAMA Internal Medicine.

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A recent webinar shared research findings and tools for health care providers to initiate conversations about cost of medication with vulnerable patients.

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The new Care Coordination Toolkit showcases the work of accountable care organizations (ACOs) participating in the Medicare Shared Savings Program and Next Generation ACO Model. The agency also released a set of case studies describing innovation ACO initiatives.

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Register For VITAL2019

Register today for the nation’s only conference designed for essential hospitals. VITAL2019 will provide you with the knowledge necessary to keep your hospital on the forefront of innovation.

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Essential Data

Our annual membership profile shows essential hospitals continue to provide more uncompensated care, treat more uninsured and Medicaid patients, and train more physicians than other U.S. hospitals.

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Volunteer With Us

As a member of the essential hospitals community, we invite you to volunteer. We have opportunities for everyone – from long-term, strategic leadership positions to short-term, project-based activities.

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