CMS seeking comments on Patients over Paperwork initiative
Editor's Note The Centers for Medicare and Medicaid Services (CMS) announced June 6 that it is seeking new ideas on how to continue the progress of its Patients over Paperwork initiative. The initiative, which was launched in fall of 2017, has already cut the “red tape” that weighs down the…
Association of changes to Hospital Readmission Reduction Program with changes in penalties
Editor's Note Stratification of hospitals in Medicare’s Hospital Readmission Reduction Program (HRRP) was associated with a significant shift in hospital penalties for excess readmissions, this study finds. Beginning in FY 2019, Medicare is stratifying hospitals into five peer groups based on the proportions of each hospital’s patient population that is…
CMS Physician Compare website lacks physician data
Editor's Note The Centers for Medicare & Medicaid Services (CMS) Physician Compare website contains quality information on just 23.3% of the more than 1 million physicians who care for Medicare patients, this study finds. A total of 76.6% of physician had no performance data, and almost none (99.7%) listed on…
Study: CMS policy changes cut readmission fines
Editor's Note The Centers for Medicare & Medicaid Services (CMS) recent changes to its Hospital Readmission Reduction Program resulted in a drop in readmission fines for academic, safety-net, and rural hospitals, this study finds. This analysis of 3,049 hospitals found that because of policy changes that now separate hospitals into…
Accuracy of surgical procedure valuations in Medicare’s Fee Schedule
Editor's Note The Center’s for Medicare and Medicaid Services (CMS) is legally responsible for setting and updating the work element of its relative value units (RVUs), which form the Medicare Physician Fee Schedule used to determine physician payments. In practice, however, updating what is known as the “work RVU” is…
Non-opioid pain management gaining favor in ASCs
Pressure to contain opioid overuse in the United States is at a boiling point. The Centers for Disease Control and Prevention reports that overdose deaths linked to opioid prescriptions have increased fivefold over the last two decades. To reduce reliance on opioid prescriptions, the Centers for Medicare & Medicaid Services…
ASCs react to 2019 regulatory changes
Each year, ambulatory surgery centers (ASCs) adapt to numerous federal regulatory policy reforms. As an example, since 2012, when the Centers for Medicare & Medicaid Services (CMS) launched the Ambulatory Surgery Center Quality Reporting (ASCQR) Program ASCs had been asking for, ASCs have reported data for a changing set of…
Government payment policies linked to hospital performance fail to improve CAUTI rates
Editor's Note This study found no evidence that value-based incentive programs (VBIPs), which link financial incentives or penalties to hospital performance, had any measurable association with changes in catheter-associated urinary tract infection (CAUTI) rates. Researchers at Boston University School of Medicine analyzed 592 hospitals across the country, and found that…
Use of ‘hot spotting’ to identify high-cost surgery patients
Editor's Note Because a subset of patients are responsible for a disproportionate share of Medicare spending, targeting high-cost patients (ie, “hot spotting”) for cost containment efforts would be an effective strategy to reduce costs in surgical patients, this study finds. Using Medicare claims data from 2010 to 2013, University of…
Effect of referring high-risk patients to local high-quality hospitals
Editor's Note In this study, complication rates and Medicare payments were significantly lower for high-risk surgical patients treated at local high-quality hospitals. Analyzing elderly Medicare patients having any of four elective inpatient surgical procedures between 2012 and 2014, researchers found that one-fourth of high-risk patients had surgery at a low-quality…
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