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…
Periop nurses key in reducing readmissions after CABG surgery
Editor's Note Perioperative nurses engaging in patient and community education to explain coronary artery bypass grafting (CABG) surgery, reinforcing recommended discharge guidelines, and serving as expert resources are key to positive outcomes and reducing readmissions, finds this review article. In 2016, the Centers for Medicare & Medicaid Services reduced payments…
CMS finalizes outpatient PPS, ASC payment system, quality reporting changes for 2018
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on November 1 announced it will update the hospital outpatient prospective payment system rates by 1.35%. The final rule also removes total knee arthroplasty from the inpatient only list along with five other procedures and adds one procedure to the…
One in five physicians intend to reduce work hours or leave the profession
Editor's Note The burden and bureaucracy of today’s practice of medicine are major factors influencing physicians’ intentions to reduce work hours or leave the profession, finds this study from the American Medical Association, Mayo Clinic, and Stanford University. Of nearly 36,000 physicians across all specialties surveyed, 6,880 (19.2%) responded. Nearly 1…
Value of voluntary bundled-payment program unclear
Editor's Note For the third year in a row, researchers with the Lewin Group couldn’t determine whether Medicare’s voluntary Bundled Payment for Care Improvement initiative cuts costs and improves care, the October 31 Modern Healthcare reports. The Centers for Medicare & Medicaid Services (CMS) funded analysis found that although providers…
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