Tag: Reimbursement

Effect of Medicare's Hospital Readmission Reduction Program on surgical readmissions

Editor's Note From 2008 to 2014, rates of postoperative readmissions declined for both Hospital Readmission Reduction Program targeted procedures (total hip and total knee replacements)--from 6.8% to 4.8%--and nontargeted procedures (colectomy, lung resection, abdominal aortic aneurysm repair, coronary artery bypass graft, aortic valve replacement, and mitral valve repair)--from 17.1% to…

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By: Judy Mathias
September 13, 2017
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CMS grants exceptions for quality reporting to ASCs in Harvey’s path

Editor's Notes The Centers for Medicare & Medicaid Services (CMS) will grant exceptions for quality reporting requirements for ambulatory surgery centers (ASCs) located in the path of Hurricane Harvey, the September 1 ASCA News reports. ASCs in affected counties and parishes in Texas and Louisiana will get exceptions without having…

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By: Judy Mathias
September 6, 2017
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Payment variation in CABG episodes of care can affect bundled payments

Editor's Note Wide variation was found in 90-day coronary artery bypass grafting (CABG) episode payments for Medicare and private payer patients in this study. The differences were driven by increased use of evaluation and management services, higher utilization of inpatient rehabilitation, and patients with multiple readmissions. In the analysis of…

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By: Judy Mathias
August 25, 2017
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Voluntary bundled-payment models shifting to outpatient procedures

Editor's Note Though the Centers for Medicare & Medicaid Services (CMS) is rolling back mandatory bundled-payment programs, it is expected to release more voluntary, outpatient-focused programs, which shifts power from hospitals to physicians, the August 21 Healthcare Finance News reports. Physician-focused does not require a hospitalization, which creates a complete…

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By: Judy Mathias
August 24, 2017
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More than 800 ICD-10 code changes coming

Editor's Note ChartLogic (Salt Lake City) is reporting that as of August 9, 2017, a total of  419 ICD-10 codes were added, 273 codes were revised, and 123 codes were being deleted, according to the August 15 Becker’s Hospital CFO Report. The changes are slated for implementation on October 1,…

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By: Judy Mathias
August 21, 2017
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Purpose of CMS readmission program questioned

Editor's Note The Centers for Medicare & Medicaid Services (CMS) Hospital Readmissions Reduction Program has only seen a drop in readmissions by 0.1% from 2013 to mid-2016, which has industry experts and hospital leaders questioning its purpose, the August 12 Modern Healthcare reports. The Affordable Care Act mandated program, which…

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By: Judy Mathias
August 14, 2017
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Medicare ‘meaningful use’ data to be submitted via QualityNet

Editor's Note The Centers for Medicare & Medicaid Services (CMS) announced August 7 that hospitals and critical access hospitals participating in  Medicare’s Electronic Health Record (EHR) Incentive Program will submit their “meaningful use” data via QualityNet rather than the EHR Incentive Program Registration and Attestation System beginning January 2, 2018,…

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By: Judy Mathias
August 9, 2017
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CMS push to value-based care leading to more burnout

Editor's Note The push by the Centers for Medicare & Medicaid Services (CMS) to transform healthcare delivery at community health centers to value-based care is increasing staff dissatisfaction and burnout, this study finds. From 2013 to 2014, clinicians and staff at 296 centers reported statistically significant declines in multiple measures…

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By: Judy Mathias
August 8, 2017
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CMS releases FY 2018 inpatient PPS final rule

Editor's Note The Centers for Medicare and Medicaid Services (CMS) on August 2 issued the FY 2018 Medicare Inpatient Prospective Payment System final rule, which updates Medicare payment and policies when patients are discharged from hospitals. The rule increases rates by 1.2%. This includes an initial market-basket update of 2.7%…

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By: Judy Mathias
August 4, 2017
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AHRQ: Cost trends for inpatient stays

Editor's Note From 2005 to 2014, the average inflation-adjusted cost of a hospital inpatient stay increased by 12.7%, from $9,500 to $10,900, according to new statistics from the Agency for Healthcare Research and Quality (AHRQ). Average costs for stays increased: 16% for Medicaid 18% for private insurance 8% for Medicare…

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By: Judy Mathias
August 2, 2017
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