CMS to give providers more options for complying with MACRA
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on September 8 announced that it will give physicians and other clinicians more options in the first year to comply with the new Medicare Access and CHIP Reauthorization Act (MACRA) quality payment program. During 2017, providers will be able to…
CJR bundled payments may penalize hospitals that treat elderly, sickest patients
Editor's Note Hospitals that care for the oldest, sickest, and most complicated patients could suffer financially under Medicare’s Comprehensive Care for Joint Replacement (CJR) bundled payment program, this study finds. The study analyzed data from more than 23,000 Michigan patients who had hip or knee replacements at 60 hospitals in a…
CMS releases payment adjustments for 2017 EHR incentives
Editor's Note The Centers for Medicare & Medicaid Services (CMS) has announced that starting October 1, 2016, hospitals that are still not meaningful users of electronic health records (EHRs) will be subjected to a reduced increase in their Inpatient Prospective Payment System rate, the September 2 Healthcare IT News reports.…
Study: Hospital readmissions sometimes save lives
Editor's Note Analyzing data on nearly 4,500 acute-care facilities, Johns Hopkins researchers found that the hospitals with the highest rates of readmissions were more likely to show better mortality scores. Data on mortality and hospital readmissions used by the Centers for Medicare & Medicaid Services (CMS) sometime fail to tell…
Bariatric surgery outcomes in accredited vs nonaccredited centers
Editor's Note In this study, the preponderance of medical evidence supports Center of Excellence accreditation for bariatric surgery centers. This meta-analysis analyzed 13 studies that included more than 1.5 million patients. Among the benefits of accreditation: 10 studies found a substantial benefit for risk-adjusted outcomes 6 studies reported a considerable…
Advisory panel recommends CMS remove total knees from inpatient-only list
Editor's Note The Advisory Panel on Hospital Outpatient Payment (HOP) on August 22 unanimously recommended that the Centers for Medicare & Medicaid Services (CMS) remove total knees from its inpatient-only list, the Ambulatory Surgery Center Association (ASCA) reports. CMS is requesting information on the feasibility of removing total knees from…
CMS: ICD-10 grace period ends October 1
Editor's Note The Centers for Medicare and Medicaid Services (CMS) on August 18 announced in its FAQ guidelines that the 1-year grace period for claims using the ICD-10 code set will end October 1. Healthcare organizations will be required to use the correct degree of specificity when coding claims. Unspecified…
Impact of race/ethnicity, socioeconomic status on readmission rates after total joints
Editor's Note The addition of race/ethnicity and socioeconomic status to the risk-adjusted algorithm for readmissions after total hips and knees used by the Centers for Medicare & Medicaid Services led to a relative-performance change in readmission rates of <3% of 1,194 hospitals in this study. Policy makers and payers should…
Physician-owned surgical hospitals performed better in VBP program
Editor's Note Medicare’s value-based purchasing (VBP) program revealed superior performance associated with physician owned surgical hospitals in this study. Researchers analyzed 3,089 hospitals that included physician-owned surgical, University HealthSystem Consortium, US News & World Report Honor Roll, Kaiser Permanente, and Accountable Care Organization hospitals. Estimated mean total performance scores were…
CMS issues final PPS rule for 2017
Editor's Note The Centers for Medicare & Medicaid Services on August 2 issued its final rule for the FY 2017 hospital inpatient prospective payment system (PPS), which increases rates by 0.95%. The 0.95% increase reflects the projected hospital market basket update of 2.7% for those hospitals that were meaningful users…
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