Survey on transition to ICD-10 finds successes, challenges
Editor's Note A survey of 298 attendees at a November 9 KPMG webinar on the transition to ICD-10 gleaned the following responses: 28% said the transition had been smooth 51% found “a few technical issues but overall successful” 11% described the transition as a “failure to operate in an ICD-10…
CMS clarifies ICD-10 implementation issues
Editor's Note The Centers for Medicare and Medicaid Services (CMS) reports that it will reprocess ICD-10 claims with National Coverage Determination and Local Coverage Determination errors automatically and at no cost to providers. CMS is also waiting to reprocess some claims with errors resulting from Local Coverage Determinations until Medicare…
OIG announces new initiatives for ASCs
Editor's Note The US Department of Health & Human Services Office of the Inspector General (OIG) released its 2016 Work Plan announcing new initiatives for ambulatory surgery centers (ASCs), the ASCA News Digest reports. The initiatives include: Review the appropriateness of Medicare’s methodology for setting ASC payment rates. Revitalize outdated…
Survey: ICD-10 has reduced hospital productivity
Editor's Note In a survey by Himagine Solutions, large hospitals reported a 30% to 45% reduction in productivity for inpatients and a 20% to 40% reduction for outpatients since implementation of the ICD-10 codes, Healthcare Informatics reports. Though loss in productivity can mean a disruption to the revenue cycle, one…
Build a strong anesthesia quality program to boost patient safety and the bottom line
Quality indicators for anesthesia For the past several years, physicians have participated in the Physician Quality Reporting System (PQRS) established by Medicare as a way to assess the quality of patient care and tie that to reimbursement. Beginning in 2015, a negative payment adjustment hit individuals and group practices whose…
Study: Readmission common after emergency general surgery
Editor's Note Readmission after emergency general surgery procedures is common and varies widely according to patient factors and diagnosis, this study finds. Of more than 177,000 patients analyzed, nearly 6% were readmitted within 30 days. The most common reasons were surgical site infections (16.9%), gastrointestinal complications (11.3%), and pulmonary complications…
NIS database used for hospital reimbursement contains major flaws
Editor's Note The Nationwide Inpatient Sample (NIS) database underreports data on patients’ weight, body mass, alcohol use, and tobacco use, finds a study from the Johns Hopkins University School of Medicine, Baltimore. Medicare uses NIS data to set reimbursement rates based on a hospital’s risk for readmissions and surgical complications. The…
Medical societies plead with Congress to fix ‘meaningful use’
Editor's Note A coalition of 111 medical societies on November 4 sent letters asking Senate and House leaders to take legislative action to pause Stage 3 of the electronic health records meaningful use program and revise Stage 2 so that it enables provider success, HealthData Management reports. Stage 3 requirements…
Medicare releases 2016 final ASC payment rule
Editor's Note On October 30, the Centers for Medicare & Medicaid Services (CMS) released the final 2016 payment rule for ambulatory surgery centers (ASCs). ASC payment rates will increase by 0.3%, which is based on a projected inflation rate of 0.8% minus a 0.5% productivity adjustment required by the Affordable…
CMS finalizes 2016 payment rules for physicians, hospitals
Editor's Note The Centers for Medicare & Medicaid Services (CMS) has issued its final rules detailing how it will pay for services provided by physicians and other healthcare professionals in 2016. Key policies finalized in the rules include: Updates to the “Two-Midnight” rule, which clarifies when inpatient admissions are appropriate…
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