Tag: Medicare

Effect of Medicare's Hospital Readmission Reduction Program on surgical readmissions

Editor's Note From 2008 to 2014, rates of postoperative readmissions declined for both Hospital Readmission Reduction Program targeted procedures (total hip and total knee replacements)--from 6.8% to 4.8%--and nontargeted procedures (colectomy, lung resection, abdominal aortic aneurysm repair, coronary artery bypass graft, aortic valve replacement, and mitral valve repair)--from 17.1% to…

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By: Judy Mathias
September 13, 2017
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CMS grants exceptions for quality reporting to ASCs in Harvey’s path

Editor's Notes The Centers for Medicare & Medicaid Services (CMS) will grant exceptions for quality reporting requirements for ambulatory surgery centers (ASCs) located in the path of Hurricane Harvey, the September 1 ASCA News reports. ASCs in affected counties and parishes in Texas and Louisiana will get exceptions without having…

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By: Judy Mathias
September 6, 2017
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Flooding from Harvey prompts HHS to declare public health emergency

Editor's Note Health and Human Services (HHS) Secretary Tom Price, MD, has declared a public health emergency because of flooding and lingering rain in the aftermath of Hurricane Harvey, the August 28 Healthcare Finance News reports. This declaration gives healthcare providers in Texas and Louisianian greater flexibility in treating people displaced by the…

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By: Judy Mathias
August 29, 2017
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Payment variation in CABG episodes of care can affect bundled payments

Editor's Note Wide variation was found in 90-day coronary artery bypass grafting (CABG) episode payments for Medicare and private payer patients in this study. The differences were driven by increased use of evaluation and management services, higher utilization of inpatient rehabilitation, and patients with multiple readmissions. In the analysis of…

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By: Judy Mathias
August 25, 2017
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More than 800 ICD-10 code changes coming

Editor's Note ChartLogic (Salt Lake City) is reporting that as of August 9, 2017, a total of  419 ICD-10 codes were added, 273 codes were revised, and 123 codes were being deleted, according to the August 15 Becker’s Hospital CFO Report. The changes are slated for implementation on October 1,…

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By: Judy Mathias
August 21, 2017
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CMS proposes canceling two bundled payment models, scaling back a third

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on August 15 announced a proposed rule that would cancel two bundled-payment models and reduce the number of providers required to participate in a third. The proposed rule would cancel the Episode Payment Models and the Cardiac Rehabilitation incentive payment…

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By: Judy Mathias
August 16, 2017
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Purpose of CMS readmission program questioned

Editor's Note The Centers for Medicare & Medicaid Services (CMS) Hospital Readmissions Reduction Program has only seen a drop in readmissions by 0.1% from 2013 to mid-2016, which has industry experts and hospital leaders questioning its purpose, the August 12 Modern Healthcare reports. The Affordable Care Act mandated program, which…

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By: Judy Mathias
August 14, 2017
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Hospitals partnering with ASCs to perform outpatient total joints

Editor's Note With the growth of ambulatory surgeries and the shift to Medicare reimbursement for outpatient hip and knee replacements, hospitals are acquiring and forming joint ventures with ambulatory surgery centers (ASCs), the August 5 Modern Healthcare reports. This allows hospitals to keep part of the revenue and better aligns…

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By: Judy Mathias
August 10, 2017
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CMS push to value-based care leading to more burnout

Editor's Note The push by the Centers for Medicare & Medicaid Services (CMS) to transform healthcare delivery at community health centers to value-based care is increasing staff dissatisfaction and burnout, this study finds. From 2013 to 2014, clinicians and staff at 296 centers reported statistically significant declines in multiple measures…

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By: Judy Mathias
August 8, 2017
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CMS releases FY 2018 inpatient PPS final rule

Editor's Note The Centers for Medicare and Medicaid Services (CMS) on August 2 issued the FY 2018 Medicare Inpatient Prospective Payment System final rule, which updates Medicare payment and policies when patients are discharged from hospitals. The rule increases rates by 1.2%. This includes an initial market-basket update of 2.7%…

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By: Judy Mathias
August 4, 2017
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