Dobson DaVanzo & Associates was commissioned by 340B Health to determine the extent to which disproportionate share (DSH) hospitals enrolled in the 340B drug pricing program focus their services on vulnerable patient populations. Under the 340B program, safety-net hospitals and other health care providers that serve the poor in large numbers can buy prescription drugs for less. Congress intended for them to use the savings to stretch scarce resources and provide more services to more patients. We found that:
• As a percentage of total patient care costs, 340B DSH hospitals provide nearly twice as much care as non-340B hospitals – 41.9 percent versus 22.8 percent – to Medicaid beneficiaries and low-income Medicare patients.
• 340B hospitals provide nearly 30 percent more uncompensated care than non-340B hospitals – $24.6 billion to $17.5 billion. Although 340B hospitals accounted for only 35 percent of all hospitals included in the analysis, 340B hospitals provided 58 percent of all uncompensated care. In addition, when taking hospital size into account and looking at uncompensated care as a percent of total patient care costs, 340B hospitals across all hospital sizes provided consistently high levels of uncompensated care.
• A higher percentage of 340B DSH hospitals provide public health and specialized services – many of which are unprofitable but essential to their communities – than non-340B hospitals.
“Three metrics have been used in the literature to describe safety-net hospitals: 1) provision of services to vulnerable populations, 2) a disproportionate amount of uncompensated care, and 3) type of care provided,” said author Joan DaVanzo. “Our analyses found that DSH hospitals participating in the 340B program surpass non-340B hospitals on all three criteria, regardless of size.”
Click here to read the report.
To learn more, please visit 340B Health at http://www.340bhealth.org/
Al Dobson and Joan DaVanzo attended the PHI 2015 Conference, "Bridging The Continuum of Care: Hospital & Post-Acute Care Integration", at the Mayflower Hotel, Washington, DC. Dr. Dobson also chaired a session entitled, "New Approaches for Discharging Hospital Patients to Post-Acute Care".
Dobson | DaVanzo is proud to announce that we will celebrate our eighth anniversary on May 15th. Over the past eight years, the firm has expanded to a seasoned staff of fifteen full-time employees, and continues to grow. We have also had the opportunity to develop relationships with wonderful new clients, and have deepened our relationships with existing clients. Over the past year, we have been extensively involved in accountable care organizations (ACO) and bundling analytics, and are currently providing monthly reports to a variety of Centers for Medicare & Medicaid Services (CMS) bundling partners. We have also expanded our government contracting work.
We look forward to continued interesting and challenging projects as the healthcare marketplace continues to explore how to more efficiently provide higher quality health care.
Al Dobson gave a presentation , "Evaluating Shared Savings Payment Policies and Promoting Data-Driven Decision-Making in the Medicare MSSP ACO Program", at the National Association of Accountable Care Organizations (NAACOS) Spring Conference, in Baltimore on April 2, 2015.
To view the presentation, please click here.
Today Dobson | DaVanzo released a study that estimates the potential Medicare savings for deferring provider payments for RAC appeals until after Administrative Law Judge (ALJ) hearing determination (Level 3). Due to significant delays in the ALJ process, requests for hearings often take around 30 months until review and determination is received, resulting in significant interest payments for CMS when reimbursing providers for successful appeals. The study analyzed data from the Office of Medicare Hearing and Appeals (OMHA) and testimony from a Chief ALJ Judge to estimate the Medicare savings for avoided interest payments under this policy. This study focuses on the savings for RAC audits for O&P services, as well as all Medicare Part B services associated with RAC Level 3 audits.
Click here to read the report.
National Association of Psychiatric Health Systems (NAPHS) commissioned Dobson | DaVanzo to define the substance use disorder population and to appraise existing policies regarding the coverage, funding, and delivery of addiction treatment. The report, "Addiction Treatment Today and Tomorrow: Implications and Policy Recommendations" notes that transformative policies (namely, the federal Mental Health Parity and Addiction Equity Act (MHPAEA) and the Affordable Care Act (ACA) have sought to improve patient access to treatment by reforming prior insurance coverage restrictions. Yet significant coverage gaps persist. The full report, along with the Dobson | DaVanzo two-page Executive Summary, is available at www.naphs.org.
On March 4, 2015, Al Dobson gave a presentation at the Select Medical CEO and Medical Director Conference in Coral Gables, Florida. His presenatation, "Market Place Considerations for Inpatient Rehabilitation Facilities Under Medicare Bundled Payment for Care Improvement (BPCI)", can be viewed by clicking here.
Al Dobson and Joan DaVanzo gave a presentation today at the Health Dimension Group (HDG) National Summit: The Pursuit of Value, in Orlando, Florida. The presentation, entitled, "Market Place Considerations For Post Acute Care Providers Under Medicare Bundled Payment for Care Improvement (BPCI) Initiative" can be viewed by clicking here.
Al Dobson recently briefed Senate staff on the findings of the Dobson | DaVanzo study on the impact of complex medical rehabilitation on patient outcomes. This study, entitled “Assessment of Patient Outcomes of Rehabilitative Care Provided in Inpatient Rehabilitation Facilities (IRFs) and After Discharge" can be found on the American Medical Rehabilitation Providers Association (AMRPA) website, or by clicking here.
Analyses of data from 262 psychiatric care facilities surveyed by Dobson | DaVanzo were released Wednesday in this year’s National Association of Psychiatric Health Systems (NAPHS) Annual Report. Findings from Dobson | DaVanzo’s analyses show a growing need for psychiatric services in inpatient hospitals based on 2011 and 2012 utilization data. The report provides trend analysis, looking at changes from year to year in NAPHS-member hospitals and residential treatment centers, as well as national averages to give a snapshot of members’ experiences in the reporting year. The report can be purchased from: https://naphs.org/resources/home.aspx?product-tab=1
Al Dobson and Joan DaVanzo co-presented at a AAMC BPCI Facilitator Convener Group Webinar, Friday, June 6, 2014. Al discussed risk of readmissions, and Joan presented case studies on current risk assessment strategies.
Al Dobson and Joan DaVanzo jointly participated in the NAACOS 2014 Spring Conference, on a panel entitled, “Managing Post-Acute Care and Risk Assessment”. Al’s presentation was on considerations for ACOs based on a payment bundling framework, while Joan’s presentation was on considerations for patient assessment in an ACO environment.
Dr. Allen Dobson and Audrey El-Gamil, along with the Alliance for Home Health Quality and Innovation (AHHQI), joined the Visiting Nurse Associations of America (VNAA) in a webinar presentation entitled "Bundling and Coordinating Post-Acute Care (BACPAC) Toolkit". The toolkit outlined new approaches for post-acute care bundled payments with the ability to improve delivery of care for patients, providers, and the entire U.S. health care system. The analysis explains issues related to the structure, components, and attributes of post-acute care payment bundles (excluding the initial acute care hospitalization) and models the financial impact of various design parameters. The webinar also summarized key findings from the Clinically Appropriate and Cost‐Effective Placement (CACEP) project, which examined how the Medicare home health benefit is currently serving Medicare beneficiaries, and how Medicare’s use of home health could better meet beneficiary needs and improve the quality and efficiency of care.
Al Dobson participated in a “roundtable discussion on emerging policy issues” at a Brandeis University Health Industry Forum held in Washington, D.C. earlier this week. The panel discussed a range of issues, including the evolution of bundled payment policy under Medicare, the implications of new preferred networks of post-acute services on patient care and on providers outside of those networks, and the impact of other likely Medicare policy changes.
Dobson | DaVanzo presented results of their study at AMRPA Spring Executive Leadership Forum today, in Washington, DC. The study, "Assessment of Patient Outcomes of Rehabilitative Care Provided in Inpatient Facilities and After Discharge", shows that when patients are matched on demographic and clinical characteristics, rehabilitation in IRFs leads to lower mortatlity, fewer readmissions and ER visits, and more days at home than rehabilitation in SNFs for the same condition.
For more information, please access the AMRPA website here.