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,…
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…
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%…
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…
Reduction in readmissions not linked to increased mortality
Editor's Note Reductions in readmissions associated with the Affordable Care Act have not had the unintended consequence of increasing mortality after hospital discharge, finds this study. Analysis of more than 5 million Medicare patients hospitalized for heart failure, heart attack, or pneumonia, found that reductions in hospital 30-day readmission rates…
CMS issues 2018 OPPS/ASC proposed payment rule
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on July 13 issued the CY 2018 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule. CMS is proposing an update of 1.9% for ASCs, which is a combination of a 2.3% inflation update…
CMS proposes paying for outpatient total joints
Editor's Note The Centers for Medicare & Medicaid Services on July 13 issued a proposed rule that updates payment rates and policy changes in the Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System. Among the proposals are that Medicare pay for knee replacement procedures performed in outpatient…
Distinguishing risk factors for SSIs after pancreatic surgery
Editor's Note Reporting of surgical site infections (SSIs) after pancreatic surgery should distinguish between superficial and organ-space infections, which will require different preventative strategies, this study finds. Results showed that risk factors for superficial and organ-space SSIs after pancreatic surgery differed. Preoperative biliary stenting was an independent risk factor for superficial…
Editorial
The inaugural Bundled Payment Bootcamp on June 20 in Nashville, Tennessee, was a timely opportunity for healthcare providers to learn how reimbursement is changing the way they do business. Though the uncertain direction of US healthcare legislation continues to cause consternation, this workshop—which will be presented again in fall 2017—clarifies…
Do Medicare's latest code changes help or hurt ASCs?
Medicare is increasing approval of higher-acuity procedures performed in the ambulatory surgery center (ASC) setting, creating meaningful opportunities for ASCs. At the same time, however, a number of outpatient procedure codes have been deleted, reduced, or are packaged and considered all-inclusive in a case, without additional payment. “Key changes occurred…
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