CMS proposes to revise physician anti-kickback rules
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on October 9 announced proposed changes to how it enforces the Physician Self-Referral Law (ie, Stark Law), which penalizes physicians and other healthcare providers for referring patients to outside services they could stand to benefit from financially. The proposed rule…
Joint Commission reviewing CMS final rules on discharge planning, burden reduction
Editor's Note The Joint Commission announced on October 9 that it is reviewing discharge planning and burden reduction changes announced in the Centers for Medicare & Medicaid Services’ (CMS) final rules published September 30. Any changes to Joint Commission accreditation requirements for deemed programs will go through the CMS iterative…
CMS: New round of readmission penalties affects 2,583 hospitals
Editor's Note Data from the Affordable Care Act’s Hospital Readmissions Reduction Program (HRRP) shows that Medicare cut payments to 2,583 hospitals on October 1 because of the number of patients readmitted within a month, the October 1 Kaiser Health News reports. The Centers for Medicare & Medicaid Services (CMS) estimates…
CMS releases final rule on discharge planning
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on September 26 released a final rule that revises discharge planning requirements for hospitals, the September 26 Becker’s Clinical Leadership & Infection Control reports. Among the requirements: Hospitals must prioritize patients’ care goals and treatment preferences during discharge planning. Hospitals…
HealthStream’s top 10 healthcare trends
Editor's Note 2019 continues to be a year of change in the healthcare industry as well as great innovation. HealthStream has broken down the top 10 trends and identifies solutions that can help an organization streamline initiatives and improve outcomes. Among the top trends: Amazon is becoming a major disrupter.…
CMS considering reimbursement for coronary interventions at ASCs
Editor's Note In a proposed rule, the Centers for Medicare & Medicaid Services (CMS) is considering whether to reimburse for percutaneous coronary interventions (PCIs) at ambulatory surgical centers (ASCs), the September 20 tctMD reports. As of May 1, 2019, approximately 22 states allowed for coronary interventions to be done outside…
Effect of ‘regression to the mean’ on excess readmissions
Editor's Note Strong evidence suggests that most declines in excess readmissions--after implementation of Medicare’s Hospital Readmission Reduction Program (HRRP)--at poorly performing hospitals can be explained by a statistical phenomenon called “regression to the mean [RTM],” this study finds. In RTM, entities farther away from the mean in one period are…
ASC Manager Issue 2
Healthcare providers have seen a steady stream of inpatient-only procedures migrate to ambulatory surgery centers (ASCs) over the past few years. Medicare is reimbursing an increasing number of procedures performed in the outpatient setting, many of them cardiovascular in nature. This issue of ASC Manager explores the development of a…
CMS to enhance Overall Hospital Quality Star Ratings
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on August 19 announced that it plans to update the quality measurement methodology of the Overall Hospital Quality Star Ratings in 2021. The Star Ratings are located on CMS’ Hospital Compare website. While the new methodology is being finalized, CMS…
Joint Commission refines requirements for practitioner credentialing, privileging, and evaluation
Editor's Note The Joint Commission announced on August 14 that accredited hospitals and critical access hospitals will be able to supplement local data with data acquired from Medicare-certified hospitals and critical access hospitals for the purposes of practitioner credentialing, privileging, and evaluation (focused and ongoing). The supplemental data may not…
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