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…
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…
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…
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…
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…
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…
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…
ASCs react to 2019 regulatory changes
Each year, ambulatory surgery centers (ASCs) adapt to numerous federal regulatory policy reforms. As an example, since 2012, when the Centers for Medicare & Medicaid Services (CMS) launched the Ambulatory Surgery Center Quality Reporting (ASCQR) Program ASCs had been asking for, ASCs have reported data for a changing set of…
Government payment policies linked to hospital performance fail to improve CAUTI rates
Editor's Note This study found no evidence that value-based incentive programs (VBIPs), which link financial incentives or penalties to hospital performance, had any measurable association with changes in catheter-associated urinary tract infection (CAUTI) rates. Researchers at Boston University School of Medicine analyzed 592 hospitals across the country, and found that…
Use of ‘hot spotting’ to identify high-cost surgery patients
Editor's Note Because a subset of patients are responsible for a disproportionate share of Medicare spending, targeting high-cost patients (ie, “hot spotting”) for cost containment efforts would be an effective strategy to reduce costs in surgical patients, this study finds. Using Medicare claims data from 2010 to 2013, University of…
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