Win A $50 Amazon Gift Card From HMS

HMS Healthcare Management SolutionsHMS Healthcare Management Solutions is giving away a $50 Amazon gift card!  Simply send an email to with the word AMAZON in the subject line to enter.  It’s that simple!

Spread a little extra holiday cheer this season!  Use your gift card to buy last minute gifts for friends and family or spend it on something for yourself!

Deadline to enter is Friday, December 14th at 5p.m.  By submitting to this contest, entrants agree to receive communication from HMS. The winner will receive notification via email on Monday, December 17.

Bristol Hospital, Vanguard Sign Letter Of Intent

Earlier this week, Bristol Hospital and Health Care Group announced it has signed a letter of intent to be acquired by Vanguard Health Systems in Nashville, Tennessee.  Vanguard owns and operates 28 acute-care and specialty hospitals in Arizona, Illinois, Massachusetts, Michigan and Texas.

Click here to read more.

Medicare, Medicaid Impacted By Fiscal Cliff

President Barack Obama and Republican House Speaker John Boehner conferred yesterday, discussing how to avert the “fiscal cliff” which looms as the end of the year approaches.  Obama and Boehner appear at an impasse over raising the two top tax rates from 33% and 35% to 36% and 39.6%.  Lawmakers are also at odds over how to curb the rapid growth of benefit programs like Medicare and Medicaid.

HMS Collecting Toys For Tots

HMS Healthcare Management Solutions is accepting new and unwrapped toys for TOYS FOR TOTS until 5p.m. on December 18th.  Donated toys will be collected by the U.S. Marines for distribution to less fortunate children in the community and beyond.

Please consider donating to TOYS FOR TOTS by bringing a new, unwrapped toy to HMS, 8 Research Parkway in Wallingford and experience the joy of giving this holiday season.

Contact us for more information and directions to our office.

HMS Care Transitions Series: State Programs

There are several programs that offer financial support for performance measurement-related activities and technical assistance for state Medicaid and Children’s Health Insurance Program (CHIP) agencies seeking to improve the safety and effectiveness of care transitions and reduce readmissions. Examples of programs include:

State Demonstrations to Integrate Care for Dual-Eligible Individuals Design Contracts: 15 states have been selected to design new approaches to better coordinate care for dual-eligible individuals. The selected states will have up to 12 months to work with stakeholders to develop a detailed demonstration model describing how the state would structure and implement an intervention that aligns the full range of Medicare and Medicaid primary care, acute care, behavioral health, and long-term supports and services. States successfully completing their design contract may be eligible to receive support to implement their demonstration models, pending federal approval and funding availability.

Who is participating: California, Colorado, Connecticut, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oklahoma, Oregon, South Carolina, Tennessee, Vermont, Washington and Wisconsin were selected to receive design contracts as part of this effort.

Resources and technical assistance provided: The Center for Medicare & Medicaid Services (CMS) will provide funding and technical assistance to the selected states to develop person-centered approaches to coordinate care across primary, acute, behavioral health, and long-term supports and services for dual-eligible individuals. CMS is also making technical assistance available to all states interested in improving services for dual-eligible individuals.

Time of start and duration of the program design period: April 2011-April 2012; implementation will occur in 2012 and beyond.

Medicaid Community Services and Long Term Supports/ Medicaid Grant Programs: In partnership with states, consumers and advocates, providers, and other stakeholders, CMS is working to create a sustainable, person-driven long-term support system in which people with disabilities and chronic conditions have choice, control and access to a full array of quality services to assure optimal outcomes, such as independence, health and quality of life.

Next week, HMS continues our Care Transitions blog series with a look at community plans, learning opportunities and the elements of a successful care transitions program.

Use Of Self-Insured Plans Continues To Increase

A new study by the Employee Benefits Research Institute (EBRI)  finds the number of U.S. workers covered by self-insured health plans continues to increase. But the plans, in which an employer assumes the financial risk for health costs rather than paying an insurance company to do so, are primarily used by large companies.

As of 2011, more than half of U.S. employees at larger companies were covered under these self-insured plans, compared to 10.8% at businesses with less than 50 employees.

Click here to read more.

SGR Formula Figures In Fiscal Cliff

Physician practices face a 26.5% cut in Medicare physician payments if Congress does not intervene by January 1, 2013. According to estimates released by the Congressional Budget Office (CBO), fixing the sustainable growth rate (SGR) formula permanently would cost over $240 billion.

Addressing the SGR formula figures largely into the combination of tax hikes and spending cuts known as the “fiscal cliff” scheduled to take effect the first of the year.

Click here to read more.

Reminder: Home Health, DME Open Door Forum Today

HMS Healthcare Management SolutionsThe next Home Health, Hospice & Durable Medical Equipment (DME) Open Door Forum is scheduled for today, Wednesday, November 28, 2012 at 2:00p.m. Eastern Time (ET).

To participate on the conference call, dial 1-800-837-1935 & Reference Conference ID: 72193272. Persons participating by phone do not need to RSVP, though calling at least 15 minutes prior to the forum start time is recommended.

For more information on Open Door Forums, including schedules and FAQ, click here.

HMS Care Transitions Series: Federal Programs

Several complementary public sector initiatives with a focus on improving care transitions are available to communities and health care systems. Below are some of the federal government programs providing various combinations of technical assistance, financial support and learning opportunities.

Federal Programs  

  • Quality Improvement Organization (QIO): In most states, the Centers for Medicare & Medicaid Services (CMS) contracts with a QIO to implement improvements in the quality of care in all settings. Information on QIO’s is available here.
  • Administration on Aging (AoA): AoAs assist individuals making decisions about long-term care. This work includes innovative interventions to facilitate the hospital discharge process and help residents of nursing facilities return to the community.

Up next: HMS continues our Care Transitions blog series with a look at the state programs in place to improve the safety and effectiveness of care transitions.

Controlling Medicare Spending By Reducing Hospital Readmissions

Last month, Medicare began imposing financial penalties against more than 2,000 hospitals, of which 307 will receive the maximum punishment, a 1% reduction in Medicare’s regular payments for every patient over the next year.  The forfeiture is part of the Hospital Readmissions Reduction Program, Section 3025 of the Patient Protection & Affordable Care Act (PPACA) in an effort to expel unnecessary care and curb Medicare spending.

Click here to read more.