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…
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…
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,…
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…
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…
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,…
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…
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…
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…
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…