HHS: Hospitals responding to incentives to reduce readmissions
Editor's Note This study from the Department of Health and Human Services (HHS) found that readmission trends are consistent with the response by hospitals to incentives to reduce readmissions, including financial penalties, as mandated by the Affordable Care Act. No evidence was found that changes in observation-unit stays accounted for…
CMS publishes Medicare fee-for-service provider and supplier lists
Editor's Note As part of efforts to improve care delivery, data sharing, and transparency, the Centers for Medicare & Medicaid Services (CMS) on February 22 published a list of Medicare fee-for-service providers and suppliers currently approved to bill Medicare. The Moratoria Provider Services and Utilization Data Tool includes interactive…
CMS proposes Medicare Advantage changes for 2017
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on February 19 announced proposed changes to the Medicare Advantage program for CY 2017, which would increase payment rates by a net 1.35%, the February 19 Modern Healthcare reports. When factoring in the risk coding tendencies, Medicare Advantage insurers’ revenue…
ICD-10 conversion uneventful in the ambulatory setting, despite worries
With several months of experience using an updated version of the International Classification of Diseases-10 (ICD-10) diagnosis coding system, most US healthcare providers, including ambulatory surgery centers (ASCs), are finding their worst fears have yet to materialize. ‘Lights would go out’ Although Medicare has not yet released data, insurance…
Study: Hospitals receive readmission penalties for factors beyond their control
Editor's Note This study of patient readmissions finds that hospitals are receiving financial penalties because of patient social determinants of health (SDH) factors (ie, race, ethnicity, payer, and household income) and not because they provide poor quality of care. Analyzing hospital readmissions at 43 children’s hospitals, researchers found that adjusting…
CMS, health insurers standardize quality measures
Editor's Note The Centers for Medicare & Medicaid Services (CMS) and major health insurance plans, in concert with physician groups and other stakeholders, on February 16 announced a new agreement to standardize measures of quality for physicians. The agreement outlines seven core measure sets to be used as a basis…
CMS extends ‘Meaningful Use’ deadline
Editor's Note The Centers for Medicare and Medicaid Services (CMS) has extended the deadline to attest to achieving “Meaningful Use” in 2015 to March 11, the February 12 MedCity News reports. The original deadline had been February 29. CMS announced the extension in an e-mail to providers and health IT…
CMS issues final rule on Medicare overpayments
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on February 11 released its final rule for reporting and repaying Medicare overpayments, as required by the Affordable Care Act. The rule requires providers and suppliers to report and return any overpayments they identify within 6 years of receipt, down…
CMS extends comment period for EHR certification, quality reporting
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on February 2 extended the deadline for sending feedback on electronic health record (EHR) certification and quality reporting to February 16, 2016. The request for information is part of an effort by CMS to streamline and reduce the burden of…
Proposed rule would allow sharing, selling of Medicare data
Editor's Note The Centers for Medicare & Medicaid Services on January 29 issued a proposed rule that will allow organizations approved as qualified entities to confidentially share or sell analyses of Medicare and private claims data to health care providers, employers, and others. The Qualified Entity Program, authorized by the…
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