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The Jayne Koskinas Ted Giovanis Foundation for Health and Policy fosters public discussion around health care policy to benefit the public good.  Through research, white papers and other projects, the Foundation serves as an honest, independent broker of ideas and actions designed to achieve the competing goals of cost reduction, expanding access and improving quality.

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Wednesday, April 11, 2018

The Problem with Peer Grouping when Adjusting for SES in Calculating Readmission Penalties

A study published this month demonstrates and quantifies problems associated with the use of peer grouping to adjust for socio-economic status (SES) in the calculation of hospital readmission penalties, and advocates adoption of a patient-level calculation developed by JKTG Foundation Executive Vice President for Research and Policy, J. Graham Atkinson.

Search Tags: SES , Medicare , Readmissions

Wednesday, September 7, 2016

Healthy Debate: The Cheetah and the Hippopotamus

Regulatory agencies need reform too allow flexibility in the regulatory processes. The problem is that the current regulatory processes have had the same type of “animal” in the same positions with the same aversion to being nimble for so long that their thought processes may not be able to change - they have too much muscle memory. To reform these systems may require new personnel with new skill sets and a new way of looking at their respective roles. In short, these regulatory systems need to be more like a Cheetah and less like a Hippo if these functions are to be performed and result in responsive changes to the fast evolving systems.

Search Tags: Healthy Debate , Medicare

Tuesday, August 9, 2016

Healthy Debate: The New Budget Neutral - A CMS License to Steal?

What happens if CMS pockets budget neutral funds (as they have done in the past)? These provisions will inherently become a “license to steal” or budget negative and the agency can do what it wants even if there is a resultant harm to beneficiaries. That’s more than a violation of their mission. It’s a problem.

Search Tags: Medicare , Healthy Debate

Tuesday, July 5, 2016

Healthy Debate: Building an SES adjustment directly into the Medicare Re-Admission Penalty (and VBP more generally) to avoid unintended consequences

Congress is considering legislation to require that CMS take account of socio-economic status (SES) in their readmission penalty calculation. The fact that action is being taken on this issue is to be applauded, as it is unconscionable that CMS has for years ignored the evidence and arguments that socioeconomic status influences readmission rates, and has penalized hospitals that treat a high proportion of patients of low SES. However, this situation also illustrates the problems that occur when legislation is required to make the regulators behave responsibly.

Wednesday, March 23, 2016

Healthy Debate: ACA 6th Anniversary - What Now?

Most people save for the unexpected but inevitable expense – a car that won’t start or a water heater that busts. Fewer Americans think to save for unexpected healthcare expenses. One key benefit of the ACA was supposed to keep people out of catastrophic medical debt by providing relatively affordable coverage. With government touting cost savings, what is the true impact on Americans?