Editorial
The Centers for Medicare & Medicaid Services (CMS) on July 12 issued a proposed rule with potential changes to the Medicare Physician Fee Schedule on or after January 1, 2019. According to CMS, the changes would increase the time available for physicians and other clinicians to spend with their patients…
Academic medical centers trailing on cost, quality measures
Editor's Note A new study by consultancy firm Navigant found that academic medical centers are trailing community hospitals across cost and quality measures. Among the findings: Cost per case was 5.8% higher at medical centers, equating to $3.1 million added annual operating expense per center. Cost per case disparity between high…
Hospitals using bundled payments report reduced SNF use and improved care integration
Editor's Note Hospitals participating in Medicare’s Comprehensive Care for Joint Replacement model or its Bundled Payments for Care Improvement initiative for lower extremity joint replacement episodes report reducing skilled nursing facility (SNF) use and improving care coordination, in this survey. Interviews of executives or administrators in each of 22 hospitals…
CMS: Changes in IPPS, LTCH PPS final rule empower patients, reduce administrative burden
Editor's Note On August 2, the Centers for Medicare & Medicaid Services (CMS) finalized its Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) rule for FY 2019. The rule will empower patients and advance the White House “MyHealthData” initiative and the CMS “Patients…
CMS releases outpatient prospective payment rule
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on July 25 released its 2019 outpatient prospective payment rule, which includes cutting payments for hospital outpatient clinic visits as part of a site neutral payment policy. CMS estimated this would save patients about $150 in lower copayments for clinic…
Editorial
Value-based payment (VBP) models of patient care have not been shown to effectively reduce healthcare costs, according to a recent report from the Healthcare Financial Management Association (HFMA). But that conclusion comes with several caveats, such as: • It’s too soon to have data on programs like the Medicare Shared…
Association between skilled nursing facility use and postop readmission rates
Editor's Note Use of postacute care in skilled nursing facilities (SNFs) for total hip replacement (THR) and coronary artery bypass grafting (CABG) patients was not associated with changes in readmission rates, in this study. Of 176,994 CABG patients at 804 hospitals and 233,955 THR patients at 1,220 hospitals, SNF use…
Preventability of early vs late readmissions
Editor's Note Preventability of readmissions changes with time, this study finds. Readmissions within the first week after discharge were more likely to be preventable by hospital-based interventions, whereas later readmissions were less likely to be preventable and more amenable to ambulatory and home-based interventions. This analysis of 822 patients readmitted…
CMS proposes changes to modernize Medicare, restore physician-patient relationship
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on July 12 issued a proposed rule that includes updated payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule on or after January 1, 2019. Physician fee schedule rates will be updated by…
Study: CMS policy on CLABSI, CAUTI has minimal effect on reimbursement
Editor's Note This study found that the Centers for Medicare & Medicaid Services (CMS) hospital-acquired conditions policy on central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI) had minimal financial effects on hospitals because billing codes for CLABSI and CAUTI were rarely used and there was a significant…
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