This blog is written by Mr. Steven C. Schurr, Esq. and focuses on health care law matters that pertain to food and drug law, regulatory compliance, privacy rights, insurance coverage, state and federal disability coverage, patient advocacy issues, and mental health coverage and treatment.

Monday, October 29, 2012

Contents of Obamacare - Part 7 - Linking Payment to Quality Outcomes

Improvements to Medicaid System: These include coverage for freestanding birth centers, more home health care, increased rebates for pharmaceuticals, coverage of drugs for smoking cessation, refusal to pay hospitals for treatment of hospital-acquired infections. Special Rules for Native Americans: Native Americans and Alaskans have no cost-sharing if they enrolled in a qualified state exchange and their income is less than 300% of the Federal poverty level. Maternal and Child Health Services: The states are to provide reports and the Federal government is to offer grants to enhance home visitation treatments for disadvantaged communities with higher than average levels of premature birth, child abuse, and other social problems. Postpartem Conditions: The act provides funding for the study and treatment of postpartum depression and psychosis. Personal Responsibility Education Programs: The act provides grants for innovative programs to promote individual responsibility in regards to sexual abstinence and birth control for the prevention of sexually transmitted diseases. Improving the Quality and Efficiency of Health Care: The preceding statement is the name of Title III of the Act. Subtitle A is called “Transforming the Health Care Delivery System” Linking Payment to Quality Outcomes Under the Medicare Program: This program pertains to five medical events: heart attacks, heart failure, pneumonia, surgical infections and hospital-acquired infections. Hospitals shall be given pay incentives for Medicare patients if they successfully treat and discharge the subject without a readmission. Likewise, payment to physicians will be based upon quality outcomes moreso that the number and cost of procedures that the MD performs. Hospitals shall be penalized in their payment amounts if their patients suffer from hospital-acquired infections. Intragency Working Group in Health Care Quality: The group contains senior executives from the Department of Health and Human Services , the Center for Medicare and Medicaid Services, the National Institutes of Health, the Center for Disease Control, Food and Drug Administration, Health Resources and Services Administration, Agency for Healthcare Research and Quality, Office of the Nation Coordinator for Health Information Technology, Substance Abuse and Mental Health Services Administration, Administration for Children and Families, Department of Commerce, Office of Management and Budget, Bureau of Federal Prisons, United States Coast Guard, National Highway Traffic Safety Administration, Federal Trade Commission, Social Security Administration, Department of Labor, United States Office of Personnel Management, Department of Defense, Department of Education, Department of Veterans Affairs, Veterans Health Administration, and “any other appropriate federal agency”. This “Justice League” of representatives from Federal agencies is supposed to coordinate activities to avoid duplication and maximize results for national health care priorities.

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