Tag: CMS

Hospital-based care coordination strategies linked to CMS star ratings

Editor's Note Care coordination strategies were found to be associated with high overall hospital quality star ratings from the Centers for Medicare & Medicaid Services (CMS) in this study. A total of 710 general acute care noncritical access hospitals that received star ratings and responded to the 2015 American Hospital…

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By: Judy Mathias
November 21, 2019
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A primer for starting a total joint replacement program

Ambulatory surgery centers (ASCs) have increasing incentives to offer total joint replacements (TJR) as Medicare expands the list of covered procedures. However, there’s a lot to consider in this particular service line. “There are many things to arrange that aren’t required with other service lines, particularly as home care of…

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By: OR Manager
November 18, 2019
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Improving prediction of adverse surgical outcomes with machine learning algorithm

Editor's Note In this study, a new machine learning Complexity Score algorithm outperformed three commonly used risk scores in predicting postoperative morbidity, 30-day readmission, 90-day readmission, and postoperative surper-use. Study patients underwent colectomy, abdominal aortic aneurysm repair, coronary artery bypass grafting, total hip or knee replacement, or lung resection. The…

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By: Judy Mathias
November 6, 2019
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CMS releases 2020 final payment rule for ASCs, HOPDs

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on November 1 released its final payment rule for ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs). CMS added eight codes to the ASC-payable list, including total knee arthroplasty. CMS also removed total hip arthroplasty and seven spine codes from…

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By: Judy Mathias
November 4, 2019
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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…

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By: Judy Mathias
October 10, 2019
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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…

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By: Judy Mathias
October 10, 2019
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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…

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By: Judy Mathias
October 2, 2019
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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…

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By: Judy Mathias
October 1, 2019
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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.…

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By: Judy Mathias
September 26, 2019
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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…

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By: Judy Mathias
September 24, 2019
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