CMS Rejects Ohio’s Section 1115 Medicaid Demonstration Waiver Application – On September 9, 2016, CMS denied Ohio’s application for a new demonstration section 1115 Medicaid waiver, citing concerns over the State’s request to charge certain of its Medicaid beneficiary population premiums, regardless of income.  CMS was concerned that the premiums would undermine access to coverage and the affordability of care.  Under Ohio’s proposed waiver application, previously reported here, individuals would be excluded from coverage indefinitely until they pay all amounts owed in arrears.  CMS noted that this policy could lead to a substantial population without access to affordable healthcare coverage.  CMS stated in its denial letter available here, that it has not approved this type of policy in any state because it does not support the objectives of the Medicaid program.

Almost Every State Seeing Hospital Readmission Rates Falling – In a blog post, CMS announced that 49 states, plus Washington, D.C., saw hospital readmission rates fall between 2010 and 2015.  CMS calculated the number of readmissions occurring within 30 days of a patient’s discharge and found that 11 states saw a decline in over 10 percent and 43 over 5 percent.  On average, readmission rates dropped by 8 percent nationally.  Only Vermont saw an increase in readmissions, but only at 0.70 percent (or an additional 21 readmissions).  CMS estimated that this national reduction in readmissions means that approximately 100,000 inappropriate readmissions were avoided in 2015.  CMS credited the reduction to its Hospital Readmissions Reduction Program, as well as other initiatives including Accountable Care Organizations, Quality Improvement Organizations and Hospital Engagement Networks.  The blog post is available here.