CMS proposes coverage change for MRI with implanted cardiac devices
Editor's Note The Centers for Medicare & Medicaid Services on January 11 issued a proposal to modify its national coverage determination for magnetic resonance imaging (MRI) to include patients who have implanted cardiac devices. Proposed changes include the expansion of coverage for patients with cardiac devices that are approved or…
CMS announces new voluntary bundled payment model
Editor's Note The Centers for Medicare and Medicaid Services (CMS) on January 9 announced a new voluntary bundled payment model called, “Bundled Payments for Care Improvement Advanced” (BPCI Advanced). Participants in BPCI Advanced will receive payments for performance on 32 (29 inpatient, 3 outpatient) different clinical episodes. The first cohort…
CMS launches new data submission system for Quality Payment Program
Editor's Note The Centers for Medicare & Medicaid Services (CMS) announced on January 2 that physicians and other eligible clinicians participating in the Quality Payment Program can begin submitting their 2017 performance data using a new system on the Quality Payment Program website (qpp.cms.gov). The new system is an improvement…
Editorial
Efforts in 2017 to dismantle the Affordable Care Act (ACA) were largely unsuccessful, but a tax reform bill that includes a provision to abolish the ACA’s individual insurance mandate seems likely to pass. As a result, 13 million fewer Americans will be insured by 2027, and premiums will go up…
Where are you on the value-based care continuum?
Healthcare providers are straddling a variety of payment models while many regulatory changes remain in flux under the Trump Administration. Although the shift from fee-for-service to value-based payment began some years ago, not everyone is on board. Opinions about bundled payments also remain mixed, despite reports of improved outcomes and…
ASC quality reporting deadlines moved up in 2018
On November 1, 2017, the Centers for Medicare & Medicaid Services (CMS) released its final rule for the 2018 Medicare Hospital Outpatient Prospective Payment System/ASC Payment System and Quality Reporting Programs. In summary, several ambulatory surgery center (ASC) measures (ASC-1 to ASC-14) are unaffected, except that three measures (ASC-5, -6,…
Impact of reducing postop complications in bariatric Medicare patients
Editor's Note Hospitals with the largest reductions in serious complications after bariatric surgery had the greatest decrease in per-patient Medicare payments, this study finds. Analyzing 37,329 Medicare patients undergoing bariatric surgery from 2005 to 2006 and 2013 to 2014, researchers found a strong association between reductions in complications and decreased…
CMS finalizes changes to bundled-payment models
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on November 30 announced a final rule that cancels the mandatory hip fracture and cardiac bundled-payment models, which were to begin on January 1, 2018, and implements changes to the Comprehensive Care for Joint Replacement (CJR) Model. In the final…
Association of HRRP with surgical readmissions
Editor's Note The Hospital Readmissions Reduction Program (HRRP) decreased readmissions for targeted procedures, but no association was found for nontargeted procedures in this study. This analysis of 672,135 Medicare patients treated at 2,773 hospitals included 507,663 patients who had total knee or hip arthroplasty procedures (targeted) and 164, 472 who…
Medicare readmission reduction program linked to increased mortality rates
Editor's Note The Centers for Medicare & Medicaid Services (CMS) Hospital Readmissions Reduction Program has had the unintended consequence of increased short- and long-term mortality in heart failure patients, this study finds. Five years ago, as part of the Affordable Care Act, federal policy makers introduced the Hospital Readmission Reduction…
Free Daily News
- FDA designates Class 1 recall for tracheostomy tubes
- Study: Preventing antibiotic-resistant infection surge could save millions
- Face transplant survival rates “encouraging,” global study finds
- Vertical integration reshaping US healthcare: Impact on cost, access
- ChristianaCare, Atlas Healthcare form joint venture to expand ASC network
- CMS calls for demonstrations of AI technology in healthcare
- Study: Adjuvant nivolumab reduces risk of death, lung cancer recurrence
- Analysis: Hospital safety, quality measures surpass pre-pandemic levels
- FDA: Class 1 infusion system recall expanded
- Anesthesia staffing, communication, patient safety: Q&A with OR Manager Conference speakers