First year analysis of CJR bundled payment model
Editor's Note This interim analysis of the first year of the Comprehensive Care for Joint Replacement (CJR) bundled payment model finds that CJR may reduce institutional postacute care. Of 75 metropolitan statistical areas (MSAs) that were assigned the bundled payment model and 121 control MSAs, the mean percentage of discharges…
Study: Physicians, patients dissatisfied with EHRs
Editor's Note In this study, researchers at Lehigh University, Bethlehem, Pennsylvania, found that physicians and patients alike are dissatisfied with the use of electronic health records (EHRs). Researchers surveyed patients, physicians, mid-level providers, and nonclinical staff at two OB-GYN practices and a regional hospital from 2009 to 2013 during implementation…
Orthopedic bundled payment models on the fast track--Part 1
The Centers for Medicare & Medicaid Services (CMS) is poised to launch Bundled Payments for Care Improvement (BPCI) Advanced on October 1, 2018, and is continuing its Comprehensive Care for Joint Replacement (CJR) bundled payment model for total hip and knee arthroplasty (THA, TKA). “Orthopedics is the most important service…
Editorial
The Centers for Medicare & Medicaid Services (CMS) on July 12 issued a proposed rule with potential changes to the Medicare Physician Fee Schedule on or after January 1, 2019. According to CMS, the changes would increase the time available for physicians and other clinicians to spend with their patients…
Hospitals using bundled payments report reduced SNF use and improved care integration
Editor's Note Hospitals participating in Medicare’s Comprehensive Care for Joint Replacement model or its Bundled Payments for Care Improvement initiative for lower extremity joint replacement episodes report reducing skilled nursing facility (SNF) use and improving care coordination, in this survey. Interviews of executives or administrators in each of 22 hospitals…
EHRs are top factor contributing to physician burnout
Editor's Note A recent Reaction Data survey of 254 physicians found that 21% believed electronic health records (EHRs) were the biggest determinant in burnout, followed by payers/preauthorization, regulatory compliance, and internal bureaucracy, the July 31 Healthcare Informatics reports. All factors had a common theme of consuming time and preventing physicians…
US House votes to kill medical device tax
Editor's Note A bill that would repeal the medical device tax cleared the House of Representatives on July 24 in a 283-132 vote. the July 24 The Hill reports. The tax provided part of the funding for the Affordable Care Act. Rep Erik Paulsen (R-Minn), the bill sponsor, says the…
Editorial
Value-based payment (VBP) models of patient care have not been shown to effectively reduce healthcare costs, according to a recent report from the Healthcare Financial Management Association (HFMA). But that conclusion comes with several caveats, such as: • It’s too soon to have data on programs like the Medicare Shared…
Association between skilled nursing facility use and postop readmission rates
Editor's Note Use of postacute care in skilled nursing facilities (SNFs) for total hip replacement (THR) and coronary artery bypass grafting (CABG) patients was not associated with changes in readmission rates, in this study. Of 176,994 CABG patients at 804 hospitals and 233,955 THR patients at 1,220 hospitals, SNF use…
Preventability of early vs late readmissions
Editor's Note Preventability of readmissions changes with time, this study finds. Readmissions within the first week after discharge were more likely to be preventable by hospital-based interventions, whereas later readmissions were less likely to be preventable and more amenable to ambulatory and home-based interventions. This analysis of 822 patients readmitted…
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