Hospitals with high readmission rates penalized for the patients they serve
Clinical and social characteristics not included in Medicare’s current risk-adjustment methods explained much of the difference in readmission risk between patients admitted to hospitals with higher versus lower readmission rates, a study finds. The Medicare Hospital Readmissions Reduction Program penalizes hospitals with higher than expected 30-day readmission rates by reducing…
SSI risk after c-section twice as high for Medicaid patients
Editor's Note Medicaid patients had a twofold higher risk of surgical site infections (SSIs) after cesarean delivery than privately insured patients, this study finds. The higher risk remained even after adjusting for demographic and clinical variables. Medicaid might represent factors the study did not account for, such as socioeconomic status…
Validity of CAUTI metric used for value-based purchasing questioned
Editor's Note Two different measurement systems are used to track performance in lowering the rate of catheter-associated urinary tract infections (CAUTIs). The Agency for Healthcare Research and Quality metric has shown a 28.2% decrease in CAUTIs since 2010, whereas the Centers for Disease Control and Prevention’s metric has shown a…
ASCs report high use of Safe Surgery Checklist
Editor's Note The Centers for Medicare & Medicaid Services on October 8 released data showing that 99% of Medicare-certified ambulatory surgery centers (ASCs) use a Safe Surgery Checklist, the ASC Association reports. The data was collected in 2012 and made public on Medicare’s Hospital Compare website. Today, the Centers for…
CMS issues final rules on “meaningful use”
Editor's Note The Centers Medicare & Medicaid Services on October 6 released final rules on “meaningful use” for electronic health records. The rules cover three components of the electronic health records meaningful use program: It finalizes modifications to stages 1 and 2, covers requirements for stage 3, and it addresses the…
CMS unsure of ICD-10 readiness until processing begins
Editor's Note A Government Accountability Office study finds that although extensive testing of transition to ICD-10 codes has been done, the Centers for Medicare & Medicaid Services (CMS) will not know the true functionality of the systems until code processing begins October 1, Becker’s Health IT & CIO Review reports.…
Deadline looms for CMS orthopedic bundled care program
Only a few months remain before the Comprehensive Care for Joint Replacement (CCJR) goes into effect on January 1, 2016. This orthopedic bundled program, mandated by the Centers for Medicare & Medicaid Services (CMS), is expected to save $153 million as part of the goal to convert 50% of Medicare…
Most Medicare ACOs received no bonuses in 2014
Editor's Note Only 97 of 353 Medicare accountable care organizations (ACOs) met targets for quality and slowed spending enough to earn bonuses in 2014, Modern Healthcare reports. This is a continuation of mixed results for the ACO initiative that the Obama administration has targeted for rapid expansion through 2018. The…
CMS announces additional participants for bundled payment initiative
Editor's Note The Centers for Medicare & Medicaid Services announced on August 13 that 360 more organizations have entered into agreements to assume financial risk for an episode of care during the second phase of the Bundled Payments for Care Improvement Initiative. The initiative is testing four bundled payment models…
Editorial
The French proverb, “the more things change, the more they stay the same,” is one way to view the readmission penalties imposed by the Centers for Medicare & Medicaid Services (CMS). About a year ago, a Kaiser Health News report said more than 2,600 hospitals in fiscal year 2015 were…
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