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…
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…
Academic medical centers trailing on cost, quality measures
Editor's Note A new study by consultancy firm Navigant found that academic medical centers are trailing community hospitals across cost and quality measures. Among the findings: Cost per case was 5.8% higher at medical centers, equating to $3.1 million added annual operating expense per center. Cost per case disparity between high…
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…
CMS requires hospitals to post prices online
Editor's Note Part of the Centers for Medicare and Medicaid Services (CMS) final Hospital Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System rule for FY 2019, issued August 2, was a requirement that hospitals post the prices they charge for surgeries and other medical procedures online. The…
CMS: Changes in IPPS, LTCH PPS final rule empower patients, reduce administrative burden
Editor's Note On August 2, the Centers for Medicare & Medicaid Services (CMS) finalized its Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) rule for FY 2019. The rule will empower patients and advance the White House “MyHealthData” initiative and the CMS “Patients…
CMS proposes changes to modernize Medicare, restore physician-patient relationship
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on July 12 issued a proposed rule that includes updated payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule on or after January 1, 2019. Physician fee schedule rates will be updated by…
Accuracy of Medicare’s HACRP to identify outlier hospitals for SSIs
Editor's Note Medicare’s Hospital Acquired Condition Reduction Program’s (HACRP) measure for surgical site infections (SSIs) after hysterectomy and colectomy unfairly places hospitals that are not statistical outliers at risk for financial penalties, this study from the University of Michigan finds. SSIs occurred in 1.1% of hysterectomies and 4.8% of colectomies…
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