Success in efforts to prevent HAPUs may depend on data sources
Editor's Note Transitioning from administrative data to chart-based surveillance review to measure hospital-acquired pressure ulcers (HAPUs) and accounting for HAPU severity could improve the validity of measures for assessing the clinical and financial impact of value-based purchasing interventions, this study finds. Assessing HAPU incidence, severity, and trends using administrative data…
Early action advised to achieve better OAS CAHPS responses
Mandatory implementation of the Consumer Assessment of Healthcare Providers and Systems Outpatient and Ambulatory Surgery Survey (OAS CAHPS) originally scheduled for 2018 has been delayed, but that does not mean it should be ignored, say ambulatory surgery center (ASC) leaders. The earliest projected date when the survey could become mandatory…
CMS: 1,299 providers join new bundled payment initiative
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on October 9 announced that 1,299 healthcare providers are participating in its new Bundled Payments for Care Improvement−Advanced model, which began October 1 and will continue until December 31, 2023. The program includes 32 bundled clinical episodes (29 inpatient, 3…
For-profit hospitals linked to higher readmission rates
Editor's Note Patients who receive care in for-profit hospitals are more likely to be readmitted than patients in nonprofit public hospitals, this study finds. Using data from 14,307 hospital reports from the national Hospital Readmission Reduction Program for six major diseases, including coronary artery bypass grafting and total hip and…
CMS plans innovative new VBP models
Editor's Note The Centers for Medicare and Medicaid Services (CMS) will be unveiling new payment models centered on high-cost areas as part of ongoing efforts to advance value-based payment (VBP) care, and some models could be mandatory, the September 20 Healthcare Finance News reports. Healthcare providers can expect reduced regulatory…
Orthopedic bundled payment models on the fast track--Part 2
According to a 2016 McKesson report, payers expect value-based reimbursement, including bundled payments, to grow from a third of their business to a majority of it in 5 years. And as noted in Part 1 of this two-part series (OR Manager, September 2018, 1, 13-17), bundles are advancing on multiple…
Effectiveness, safety of bariatric procedures in Medicare patients
Editor's Note Limited evidence exists about the comparative effectiveness and safety of bariatric surgical procedures in Medicare patients, this review study finds. Of 16 studies analyzed, researchers found that bariatric surgery overall, and in particular Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and adjustable gastric banding (AGB) appeared to be…
Effect of Medicare’s bundled payment program on volume, case mix
Editor's Note Hospital participation in Medicare’s Bundled Payments for Care Improvement (BPCI) program for lower extremity joint replacement (LEJR) was not associated with changes in overall procedural volume or the majority of patient case-mix factors, this study finds. The analysis of 1,717,243 Medicare patients found hospital participation in the BPCI…
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…
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…
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