HFMA NEWS

The Centers for Medicare and Medicaid Services (CMS) did a better job of getting the final hospice conditions of participation rule out than it expected, releasing the rule just after publishing an extension earlier this week. The final rule revises the existing conditions of participation that hospices must meet to participate in the Medicare and Medicaid programs. It focuses on the care delivered to patients and their families by hospices and the outcome of that care, and allows hospices flexibility in meeting quality standards.

The rule has been delivered to the Federal Register and will be published June 5. Download the rule.

The United States could reduce total healthcare spending and improve the quality of patient care if the plan proposed May 29 by America’s Health Insurance Plans (AHIP) was implemented, say analysts at PricewaterhouseCoopers. They reviewed AHIP’s proposals and estimates and concluded that if these proposals are fully implemented, the nation’s total healthcare expenditures could be $145 billion lower than currently projected by the year 2015.

The AHIP proposal would cover every American through a public-private, federal-state approach. In December 2007, AHIP’s board released a proposal to guarantee access to healthcare coverage in the individual market and announced support for third-party review of rescission decisions and their commitment to limiting pre-existing condition exclusions.

“The nation faces complex healthcare challenges and only an integrated strategy that addresses costs, quality, and access will bend the cost curve and allow the country to ensure that all Americans have access to affordable health care,” said Karen Ignagni, president and CEO of AHIP. Download the proposal.

In 2005, about 60 percent of the adult U.S. civilian noninstitutionalized population age 18 and over had at least one chronic condition, according to a new study published by the Agency for Healthcare Research and Quality. The proportion of adults with at least one chronic condition increased dramatically with age, ranging from 36.4 percent of young adults age 18-34 to 91.5 percent of the elderly age 65 and over. The proportion of persons with two or more chronic conditions also rose dramatically with age, ranging from only 14.4 percent among individuals age 18-34 to 76.6 percent of the elderly age 65 and over. Read the statistical brief.