93% of eligible clinicians received MIPS payment under QPP last year
Editor's Note New data from the Centers for Medicare & Medicaid Services (CMS) shows that 93% of eligible clinicians who participated in the Merit-Based Incentive Payment System (MIPS) under the Quality Payment Program (QPP) received positive payment adjustments for their performance last year, the November 9 EHR Intelligence reports. Only…
Success in efforts to prevent HAPUs may depend on data sources
Editor's Note Transitioning from administrative data to chart-based surveillance review to measure hospital-acquired pressure ulcers (HAPUs) and accounting for HAPU severity could improve the validity of measures for assessing the clinical and financial impact of value-based purchasing interventions, this study finds. Assessing HAPU incidence, severity, and trends using administrative data…
Early action advised to achieve better OAS CAHPS responses
Mandatory implementation of the Consumer Assessment of Healthcare Providers and Systems Outpatient and Ambulatory Surgery Survey (OAS CAHPS) originally scheduled for 2018 has been delayed, but that does not mean it should be ignored, say ambulatory surgery center (ASC) leaders. The earliest projected date when the survey could become mandatory…
CMS: 1,299 providers join new bundled payment initiative
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on October 9 announced that 1,299 healthcare providers are participating in its new Bundled Payments for Care Improvement−Advanced model, which began October 1 and will continue until December 31, 2023. The program includes 32 bundled clinical episodes (29 inpatient, 3…
CMS easing safety-net hospitals’ readmission penalties
Editor's Note The Centers for Medicare and Medicaid Services (CMS), on orders from Congress, is easing its annual readmission penalties on hospitals servicing low-income residents, the September 26 Kaiser Health News reports. The penalties are part of the Affordable Care Act’s effort to encourage better care. The sanctions have been…
For-profit hospitals linked to higher readmission rates
Editor's Note Patients who receive care in for-profit hospitals are more likely to be readmitted than patients in nonprofit public hospitals, this study finds. Using data from 14,307 hospital reports from the national Hospital Readmission Reduction Program for six major diseases, including coronary artery bypass grafting and total hip and…
CMS plans innovative new VBP models
Editor's Note The Centers for Medicare and Medicaid Services (CMS) will be unveiling new payment models centered on high-cost areas as part of ongoing efforts to advance value-based payment (VBP) care, and some models could be mandatory, the September 20 Healthcare Finance News reports. Healthcare providers can expect reduced regulatory…
Orthopedic bundled payment models on the fast track--Part 2
According to a 2016 McKesson report, payers expect value-based reimbursement, including bundled payments, to grow from a third of their business to a majority of it in 5 years. And as noted in Part 1 of this two-part series (OR Manager, September 2018, 1, 13-17), bundles are advancing on multiple…
What are the top challenges for today's ASC leaders?
We asked some top ambulatory surgery center (ASC) leaders, including members of OR Manager’s Editorial Advisory Board, to identify the top challenges ASC leaders are facing. Here are their responses. We believe you will see some of your own challenges reflected in their comments. Mary Stewart, MSN, BSN, RN…
Value-based payment models moving forward
Editor's Note Accountable care organizations (ACOs) and other value-based payment (VBP) models are increasing in the US, and there is no longer any question of whether private payers and the Centers for Medicare and Medicaid Services (CMS) will continue to support value-based payments, according to the August 14 Health Affairs…
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