CMS easing safety-net hospitals’ readmission penalties
Editor's Note The Centers for Medicare and Medicaid Services (CMS), on orders from Congress, is easing its annual readmission penalties on hospitals servicing low-income residents, the September 26 Kaiser Health News reports. The penalties are part of the Affordable Care Act’s effort to encourage better care. The sanctions have been…
Effect of Medicaid expansion on disparities in use of regionalized surgery at high-volume hospitals
Editor's Note The Affordable Care Act’s (ACA’s) Medicaid expansion had no effect on the utilization rates of regionalized surgery at high-volume hospitals (HVHs) overall or on disparities in vulnerable populations, this study finds. In this analysis of 166,558 adults at 468 hospitals who had one of four surgical procedures in…
Value-based payment models moving forward
Editor's Note Accountable care organizations (ACOs) and other value-based payment (VBP) models are increasing in the US, and there is no longer any question of whether private payers and the Centers for Medicare and Medicaid Services (CMS) will continue to support value-based payments, according to the August 14 Health Affairs…
Study: Physicians, patients dissatisfied with EHRs
Editor's Note In this study, researchers at Lehigh University, Bethlehem, Pennsylvania, found that physicians and patients alike are dissatisfied with the use of electronic health records (EHRs). Researchers surveyed patients, physicians, mid-level providers, and nonclinical staff at two OB-GYN practices and a regional hospital from 2009 to 2013 during implementation…
Joint Commission: Additional changes made to elements of performance
Editor's Note The Joint Commission announced on August 15 that additional changes will be made to elements of performance (EPs) in the Nursing and Provision of Care, Treatment, and Services chapters of the accreditation manuals for critical access hospitals and deemed-status hospital programs, effective January 1, 2019. The Centers for…
Academic medical centers trailing on cost, quality measures
Editor's Note A new study by consultancy firm Navigant found that academic medical centers are trailing community hospitals across cost and quality measures. Among the findings: Cost per case was 5.8% higher at medical centers, equating to $3.1 million added annual operating expense per center. Cost per case disparity between high…
CMS requires hospitals to post prices online
Editor's Note Part of the Centers for Medicare and Medicaid Services (CMS) final Hospital Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System rule for FY 2019, issued August 2, was a requirement that hospitals post the prices they charge for surgeries and other medical procedures online. The…
CMS: Changes in IPPS, LTCH PPS final rule empower patients, reduce administrative burden
Editor's Note On August 2, the Centers for Medicare & Medicaid Services (CMS) finalized its Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) rule for FY 2019. The rule will empower patients and advance the White House “MyHealthData” initiative and the CMS “Patients…
CMS releases outpatient prospective payment rule
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on July 25 released its 2019 outpatient prospective payment rule, which includes cutting payments for hospital outpatient clinic visits as part of a site neutral payment policy. CMS estimated this would save patients about $150 in lower copayments for clinic…
CMS proposes changes to modernize Medicare, restore physician-patient relationship
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on July 12 issued a proposed rule that includes updated payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule on or after January 1, 2019. Physician fee schedule rates will be updated by…
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