Oct 1 deadline for EHR incentive program
Editor's Note First time participants in the Centers for Medicare & Medicaid Services (CMS) Electronic Health Records (EHR) Incentive Program must attest to meaningful use for a 90-day reporting period by October 1 to avoid a payment adjustment in 2017, the September 26 AHA News reports. Returning participants must report…
Novel model predicts readmission risk
Editor's Note A novel model by researchers from the Massachusetts General Hospital, Boston, uses natural language processing to predict readmission risk by incorporating physical function, cognitive status, and psychosocial support--three areas that may impact readmission but are poorly captured with structured data sources. The final model had 16 variables, a…
CMS: Readmissions fall by more than 500,000
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on September 13 announced that 30-day patient readmissions fell by an estimated 565,000 over 5 years, from 2010 to 2015. Rates declined by more than 5% in 43 states and by more than 10% in 11 states. The only state…
Hospitals still using chargemaster markups to improve revenue
Editor's Note Since Medicare adopted its prospective payment system in 1985, many hospital executives and economists have suggested that the hospital chargemaster (list of prices for all hospital procedures and supplies) is irrelevant. However, in this study, researchers found that hospitals are systematically adjusting their charge-to-cost ratios (ie, chargemaster price…
CJR bundled payments may penalize hospitals that treat elderly, sickest patients
Editor's Note Hospitals that care for the oldest, sickest, and most complicated patients could suffer financially under Medicare’s Comprehensive Care for Joint Replacement (CJR) bundled payment program, this study finds. The study analyzed data from more than 23,000 Michigan patients who had hip or knee replacements at 60 hospitals in a…
CMS releases payment adjustments for 2017 EHR incentives
Editor's Note The Centers for Medicare & Medicaid Services (CMS) has announced that starting October 1, 2016, hospitals that are still not meaningful users of electronic health records (EHRs) will be subjected to a reduced increase in their Inpatient Prospective Payment System rate, the September 2 Healthcare IT News reports.…
Advisory panel recommends CMS remove total knees from inpatient-only list
Editor's Note The Advisory Panel on Hospital Outpatient Payment (HOP) on August 22 unanimously recommended that the Centers for Medicare & Medicaid Services (CMS) remove total knees from its inpatient-only list, the Ambulatory Surgery Center Association (ASCA) reports. CMS is requesting information on the feasibility of removing total knees from…
CMS: ICD-10 grace period ends October 1
Editor's Note The Centers for Medicare and Medicaid Services (CMS) on August 18 announced in its FAQ guidelines that the 1-year grace period for claims using the ICD-10 code set will end October 1. Healthcare organizations will be required to use the correct degree of specificity when coding claims. Unspecified…
Impact of race/ethnicity, socioeconomic status on readmission rates after total joints
Editor's Note The addition of race/ethnicity and socioeconomic status to the risk-adjusted algorithm for readmissions after total hips and knees used by the Centers for Medicare & Medicaid Services led to a relative-performance change in readmission rates of <3% of 1,194 hospitals in this study. Policy makers and payers should…
Hospital cost of surgery-related pressure ulcers
Editor's Note This study found that hospital-acquired pressure ulcers add 44% to the cost of major surgical hospital stays, but the amount varies depending on length of stay. Using data from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases and the Medicare Patient Safety Monitoring System for 2011…
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