Effect of ‘regression to the mean’ on excess readmissions
Editor's Note Strong evidence suggests that most declines in excess readmissions--after implementation of Medicare’s Hospital Readmission Reduction Program (HRRP)--at poorly performing hospitals can be explained by a statistical phenomenon called “regression to the mean [RTM],” this study finds. In RTM, entities farther away from the mean in one period are…
EHR efficiency, usability, stress differ by physician gender
Editor's Note There are gender differences in how physicians perceive EHR-related stress, satisfaction, and usability, finds this study. Of 25 ICU physicians who participated in the study, 48% were men and 52% were women. Overall task performance scores were similar, but men reported significantly higher perceived EHR workload stress and…
Machine learning identifies preop risks linked to postop Medicare super-users
Editor's Note In this study of more than 1 million Medicare patients, 4.8% were super-users of healthcare and incurred 31.7% of Medicare expenditures after surgery. A machine learning approach identified the following as the most significant risk factors linked to super-utilization of healthcare in the year following surgery: hemiplegia/paraplegia weight…
Hospital revisits have increased since implementation of HRRP
Editor's Note Hospital revisits (ie, treat-and-discharge visits to ED, observation stays, or inpatient readmissions) within 30 days of discharge have increased since implementation of the Hospital Readmission Reduction Program (HRRP), this study finds. Though hospital readmissions have dropped since HRRP was implemented as part of the Affordable Care Act, there…
CMS proposes giving Medicare patients better access to cutting-edge devices
Editor's Note In its proposed rule, the Centers for Medicare & Medicaid Services (CMS) would give Medicare patients better access to innovative devices beginning next year, the July 30 MassDevice reports. CMS also says it might pay more for “certain transformative new devices” for inpatients, using a new technology add-on…
CMS maintains site-neutral cuts in 2020 proposed rule
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on July 29 issued the 2020 proposed payment rule for ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs), which would increase Medicare hospital outpatient prospective payment system rates by 2.7%. CMS is also proposing to add eight codes to…
Changes in hospital referral patterns to skilled nursing facilities under HRRP
Editor's Note The Hospital Readmission Reduction Program (HRRP), which penalizes hospitals for higher-than-expected readmission rates, did not prompt substantial changes in hospital referral patterns to skilled nursing facilities (SNFs), this study finds. However, readmissions for patients referred to SNFs decreased more than for other patients. In this analysis of nearly…
Hospital network participation not linked with improved outcomes, lower costs
Editor's Note Hospital network participation was not associated with improvements in surgical outcomes or Medicare expenditures, compared with hospitals not in a network, this study finds. In this analysis of nearly 2 million Medicare beneficiaries having general, vascular, cardiac, or orthopedic surgery between 2007 and 2014 at network (1,868) or…
Disadvantaged neighborhoods linked to higher readmission rates
Editor's Note Residing in a disadvantaged neighborhood in Maryland and being discharged from a hospital serving a large proportion of disadvantaged neighborhoods were independently associated with increased risk of readmission in this study. 2015 data from Maryland hospitals showed a 14.1% 30-day readmission rate for patients living in neighborhoods in…
CMS penalty program not linked to hospital safety improvements
Editor's Note The Centers for Medicare and Medicaid Services (CMS) hospital penalization in the Hospital Acquired Condition Reduction Program (HACRP) was not associated with significant changes in rates of hospital acquired conditions (HACs), 30-day readmissions, or 30-day mortality and does not appear to drive meaningful clinical improvements, this study finds.…
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