Tag: Reimbursement

CMS finalizes coverage policy for TAVR

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on June 21 issued final updates to its national coverage policy for Transcatheter Aortic Valve Replacement (TAVR). The update provides more flexibility in how centers meet volume requirements for performing TAVR, while emphasizing the importance of the heart team for…

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By: Judy Mathias
June 26, 2019
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Joint Commission announces new NAHQ report on quality competencies

Editor's Note The Joint Commission on June 19 announced that the National Association for Healthcare Quality (NAHQ) has issued a new report−“Key Workforce Competencies for Quality-Driven Healthcare”− that focuses on creating a new framework for competencies needed by healthcare organizations to meet new goals for quality-driven healthcare. Among the competencies:…

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By: Judy Mathias
June 19, 2019
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Editorial

The Leapfrog Group’s spring 2019 Hospital Safety Grade Report shows some progress in patient safety: an estimated 160,000 avoidable deaths nationwide, down from 205,000 in 2016. But 160,000 is a large number. “There’s still a lot of needless death and harm in American hospitals,” says Leah Binder, Leapfrog’s president and…

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By: Elizabeth Wood
June 18, 2019
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Association of changes to Hospital Readmission Reduction Program with changes in penalties

Editor's Note Stratification of hospitals in Medicare’s Hospital Readmission Reduction Program (HRRP) was associated with a significant shift in hospital penalties for excess readmissions, this study finds. Beginning in FY 2019, Medicare is stratifying hospitals into five peer groups based on the proportions of each hospital’s patient population that is…

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By: Judy Mathias
June 4, 2019
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Effect of regional anesthesia on readmission rates, costs after TKA

Editor's Note Regional anesthesia was not associated with decreased readmission rates and costs after total knee arthroplasty (TKA) in this study. In this analysis of 138,362 privately insured TKA patients 18-64 years of age, the adjusted 90-day readmission rate was 1.8% for those who did not receive regional anesthesia compared…

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By: Judy Mathias
May 21, 2019
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Diabetics have higher risks for readmissions, mortality

Editor's Note Patients with diabetes who had low blood glucose values during the last day of hospitalization had higher rates of 30-day readmission and post discharge mortality, this study finds. Examining 843,978 admissions to the VA health care system over a 14-year period, researchers found that  patients with diabetes who…

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By: Judy Mathias
May 1, 2019
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HHS lowers maximum penalties for HIPAA violations

Editor's Note The Department of Health and Human Services (HHS) on April 26 announced it is lowering the maximum civil penalty for healthcare providers, health plans, and business associates who violate the Health Insurance Portability and Accountability Act (HIPPA), based on the level of culpability. A 2013 rule created four…

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By: Judy Mathias
May 1, 2019
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Study: CMS policy changes cut readmission fines

Editor's Note The Centers for Medicare & Medicaid Services (CMS) recent changes to its Hospital Readmission Reduction Program resulted in a drop in readmission fines for academic, safety-net, and rural hospitals, this study finds. This analysis of 3,049 hospitals found that because of policy changes that now separate hospitals into…

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By: Judy Mathias
April 22, 2019
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Accuracy of surgical procedure valuations in Medicare’s Fee Schedule

Editor's Note The Center’s for Medicare and Medicaid Services (CMS) is legally responsible for setting and updating the work element of its relative value units (RVUs), which form the Medicare Physician Fee Schedule used to determine physician payments. In practice, however, updating what is known as the “work RVU” is…

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By: Judy Mathias
April 18, 2019
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Non-opioid pain management gaining favor in ASCs

Pressure to contain opioid overuse in the United States is at a boiling point. The Centers for Disease Control and Prevention reports that overdose deaths linked to opioid prescriptions have increased fivefold over the last two decades. To reduce reliance on opioid prescriptions, the Centers for Medicare & Medicaid Services…

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By: Jennifer Lubell
March 15, 2019
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