Effect of Medicare’s nonpayment program on HACs
Editor's Note Medicare’s Nonpayment Program of 2008, which withholds hospital reimbursement for costs related to hospital-acquired conditions (HACs), was associated with a decline in the incidence of selected HACs in this study. The decline was greater in hospitals with higher Medicare utilization ratios (MURs). In this analysis of nearly 868,000…
ASCA lauds passage of 21st Century Cures Act
Editor's Note The Ambulatory Surgery Center Association (ASCA) on December 7 applauded Congress for passing the 21st Century Cures Act, which includes two provisions that benefit Medicare patients and physicians in ambulatory surgery centers (ASCs). The first provision, Section 4012, directs the Department of Health and Human Services (HHS) to…
Impact of disability and social determinants on readmissions
Editor's Note Disability and social determinants of health influence readmission risk differently when added to the Medicare risk adjustment models for the three conditions Medicare focuses on for hospital payment, finds this study. Pneumonia patients who already had difficulties with activities of daily living (ADL) before admission were more likely…
CMS publishes final rule for MU reporting
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on November 1 published a final rule that will allow providers in the Electronic Health Record (EHR) incentive program who previously demonstrated meaningful use (MU) to report to any continuous 90-day reporting period in 2016 and 2017 rather than a…
Medicare VBP bonuses down for 2017
Editor's Note More than 1,600 hospitals will get Medicare bonuses in 2017 under the Hospital Value-Based Purchasing (VBP) program, which is about 200 fewer than last year, the November 2 Modern Healthcare reports. The results are concerning because fewer hospitals are getting bonuses and hospitals aren’t moving in the rankings,…
CMS releases final rule on OPPS/ASC rates
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on November 1 released a final rule that revises the hospital outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) payment system for CY 2017. According to the rule, hospital off-campus facilities will no longer be paid the same…
GAO calls for better alignment of quality measures
Editor's Note In an October 13 report, the Government Accountability Office (GAO) called for the Department of Health and Human Services (HHS) to set priorities in its effort to better align healthcare quality measures across payers and programs, and to make them truly meaningful, according to the October 14 FierceHealthcare.…
Medicare reimbursement rates set to rise 1.2% in 2017
Ask any group of ambulatory surgery center (ASC) administrators their greatest concern, and the most likely answer will be “reimbursement.” Specifically, they will say Medicare payments do not keep up with their costs and revenue expectations. It does not help that the rules and formulas established by the Centers for…
Survey: EHRs increase costs, reduce productivity
Editor's Note A Deloitte survey of physicians found that three out of four believe electronic health records (EHRs) increase practice costs, which outweigh any efficiency savings, and seven out of 10 say EHRs reduce their productivity, the October 3 Healthcare Informatics reports. Nearly two-thirds (62%) of respondents want EHRs to…
Variation in Medicare expenditures for surgical complications
Editor's Note In this study, substantial variation was observed across hospitals in Medicare episode payments for patients rescued from surgical complications, and higher payments were not associated with improved clinical performance. Medicare payments for patients rescued at the highest-cost hospitals were two- to threefold higher than the lowest-cost hospitals for…
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