Two hospitals face value-based payment - which one does your OR resemble?
H ealthcare trends come and go, but one that shows no signs of stopping is value-based payment. Just this year, the Centers for Medicare & Medicaid Services launched the Comprehensive Care for Joint Replace-ment (CCJR) model, which mandates bundled payment for two of the most common surgical procedures in the…
More than 5,000 new codes will be added to ICD-10 in FY 2017
Editor's Note The Centers for Medicare & Medicaid Services and the Centers for Disease Control and Prevention announced March 9 that about 1,900 diagnosis codes and 3,651 hospital inpatient procedure codes will be added to the ICD-10 coding system in FY 2017, AHA News Now reports. The large number of…
CMS issues ICD-10 assessment toolkit
Editor's Note The Centers for Medicare & Medicaid Services has released a toolkit to help healthcare providers track and respond to ICD-10 performance indicators. The toolkit includes tips and resources for: assessing ICD-10 progress using key performance indicators to identify potential issues that could affect productivity or cash flow addressing…
Medicare bundled payments improve outcomes for total joint patients
Editor's Note Implementing bundled payments for Medicare patients having total joint replacements resulted in improved quality of care and outcomes and reduced costs, finds this study presented March 2 at the annual meeting of the American Academy of Orthopedic Surgeons. As a pilot site for Medicare’s Bundled Payment for Care…
CMS extends ‘meaningful use’ deadline to July 1
Editor's Note The Centers for Medicare & Medicaid Services on February 26 once again extended the deadline for hardship exemptions for the “meaningful use” requirement of the electronic health records incentive payment program, Modern Healthcare reports. The new deadline for hospitals, critical access hospitals, physicians, and other eligible professionals is…
HHS: Hospitals responding to incentives to reduce readmissions
Editor's Note This study from the Department of Health and Human Services (HHS) found that readmission trends are consistent with the response by hospitals to incentives to reduce readmissions, including financial penalties, as mandated by the Affordable Care Act. No evidence was found that changes in observation-unit stays accounted for…
CMS publishes Medicare fee-for-service provider and supplier lists
Editor's Note As part of efforts to improve care delivery, data sharing, and transparency, the Centers for Medicare & Medicaid Services (CMS) on February 22 published a list of Medicare fee-for-service providers and suppliers currently approved to bill Medicare. The Moratoria Provider Services and Utilization Data Tool includes interactive…
CMS proposes Medicare Advantage changes for 2017
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on February 19 announced proposed changes to the Medicare Advantage program for CY 2017, which would increase payment rates by a net 1.35%, the February 19 Modern Healthcare reports. When factoring in the risk coding tendencies, Medicare Advantage insurers’ revenue…
Study: Hospitals receive readmission penalties for factors beyond their control
Editor's Note This study of patient readmissions finds that hospitals are receiving financial penalties because of patient social determinants of health (SDH) factors (ie, race, ethnicity, payer, and household income) and not because they provide poor quality of care. Analyzing hospital readmissions at 43 children’s hospitals, researchers found that adjusting…
CMS, health insurers standardize quality measures
Editor's Note The Centers for Medicare & Medicaid Services (CMS) and major health insurance plans, in concert with physician groups and other stakeholders, on February 16 announced a new agreement to standardize measures of quality for physicians. The agreement outlines seven core measure sets to be used as a basis…
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