Editor's Note The Centers for Medicare & Medicaid Services has released a toolkit to help healthcare providers track and respond to ICD-10 performance indicators. The toolkit includes tips and resources for: assessing ICD-10 progress using key performance indicators to identify potential issues that could affect productivity or cash flow addressing…
Editor's Note Physician practices each year spend 785 hours per physician to track and report quality measures for Medicare and private health insurers at a cost of more than $15.4 billion a year, this study finds. Eight in 10 physicians surveyed reported spending more effort on quality measures now than…
Editor's Note If all total knee replacements were performed at high-volume hospitals, it could save the US healthcare system between $2.5 and $4 billion annually by 2030, finds a study presented March 4 at the annual meeting of the American Academy of Orthopedic Surgeons. In this study of nearly 90,000…
Editor's Note Implementing bundled payments for Medicare patients having total joint replacements resulted in improved quality of care and outcomes and reduced costs, finds this study presented March 2 at the annual meeting of the American Academy of Orthopedic Surgeons. As a pilot site for Medicare’s Bundled Payment for Care…
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…
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…
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…
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…
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…
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…