Tag: CMS

CMS issues 2018 OPPS/ASC proposed payment rule

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on July 13 issued the CY 2018 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule. CMS is proposing an update of 1.9% for ASCs, which is a combination of a 2.3% inflation update…

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By: Judy Mathias
July 18, 2017
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CMS proposes paying for outpatient total joints

Editor's Note The Centers for Medicare & Medicaid Services on July 13 issued a proposed rule that updates payment rates and policy changes in the Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System. Among the proposals are that Medicare pay for knee replacement procedures performed in outpatient…

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By: Judy Mathias
July 17, 2017
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Study identifies high-risk groups for readmissions

Editor's Note Comparing rates, characteristics, and costs of hospital readmissions across all ages and insurance types, researchers from Beth Israel Deaconess Medical Center, Boston, found that of more than 12.5 million patients discharged in 2013, approximately 1.8 million were readmitted within 30 days. Medicare patients accounted for 56% of readmissions,…

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By: Judy Mathias
July 11, 2017
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CMS star ratings not linked to surgical outcomes

Editor's Note High Centers for Medicare & Medicaid Services (CMS) Overall Hospital Quality Star Ratings were not associated with improved patient outcomes in advanced laparoscopic abdominal surgery, this study finds. Morbidity at low-star hospitals was higher for colorectal surgery but not for bariatric or hiatal hernia surgery, and no significant…

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By: Judy Mathias
July 5, 2017
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Survey: Physicians unprepared for MACRA

Editor's Note A survey of 1,000 physicians by the American Medical Association and KPMG finds that fewer than one in four believe they are well prepared to meet the 2017 requirements of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), KPMG.com reported on June 28. MACRA reshapes how…

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By: Judy Mathias
July 5, 2017
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Value-based reforms linked to readmission reduction

Editor's Note Hospital participation in value-based reforms was associated with greater reductions in 30-day readmissions, this study finds. In this analysis of 2,837 hospitals between 2008 and 2015, researchers found that participation in one or more voluntary Medicare value-based reforms, which included the Meaningful Use of Electronic Health Records program,…

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By: Judy Mathias
June 6, 2017
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CMS issues guide for quality payment programs

Editor's Note The Centers for Medicare & Medicaid Services (CMS) has issued a guide summarizing technical assistance resources available to small, underserved, and rural hospitals participating in the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model (AAPM). The guide also provides resources for quality innovation networks and…

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By: Judy Mathias
June 2, 2017
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Lower readmission rates linked to Medicare's HRRP

Studies have shown an association between reduced hospital readmission rates and programs implemented as part of the Centers for Medicare & Medicaid Services’ (CMS) Hospital Readmission Reduction Program (HRRP) to reduce healthcare costs and improve quality of care. Researchers from the University of Michigan in Ann Arbor and the RAND…

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By: Elizabeth Wood
May 17, 2017
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Effect of Medicare’s Nonpayment Program on HACs

Editor's Note Medicare’s Nonpayment Program of 2008, which withholds hospital reimbursement for costs related to hospital-acquired conditions (HACs), was associated with a declined in the incidence of selected HACs, and the decline was greater in hospitals with a higher Medicare utilization ratio (MUR), this study finds. Of 867,584 Medicare patients…

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By: Judy Mathias
May 8, 2017
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Study: Most hospitals received penalties for excess readmissions

Editor's Note More than half of hospitals were penalized by the Centers for Medicare and Medicaid Services in all five years of the Hospital Readmission Reduction Program (HRRP) initiated by the Affordable Care Act, this study finds. Among the study findings: Penalties doubled since the beginning of the program, from…

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By: Judy Mathias
May 2, 2017
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