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…
CMS extends deadline for new alternative bundled payment model
Editor's Note The Centers for Medicare & Medicaid Services (CMS) announced that it is extending the deadline for its new alternative bundled payment model from August 1 to August 8, the July 5 Modern Healthcare reports. CMS extended the deadline after receiving complaints from providers and hospitals that they weren’t…
Accuracy of Medicare’s HACRP to identify outlier hospitals for SSIs
Editor's Note Medicare’s Hospital Acquired Condition Reduction Program’s (HACRP) measure for surgical site infections (SSIs) after hysterectomy and colectomy unfairly places hospitals that are not statistical outliers at risk for financial penalties, this study from the University of Michigan finds. SSIs occurred in 1.1% of hysterectomies and 4.8% of colectomies…
Effect of price transparency on ASCs
Editor's Note In this survey of six ambulatory surgery centers (ASCs), Johns Hopkins researchers led by Martin Makary, MD, MPH, found that the majority increased patient satisfaction, volume, and revenue after publicly listing the prices of common surgical procedures. Five centers reported an increase in patient volume by a median…
Homeless veterans at increased risk of postop readmission
Editor's Note For veterans having surgical procedures performed in the VA healthcare system, homelessness is an important risk factor for unplanned readmission, finds this study. Analyzing 232,373 surgical procedures performed on 199,879 patients, researchers found that 5,068 of the procedures were performed on homeless patients. The rate of readmission within…
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