Editor's Note More than 500,000 physicians and other providers will get a 2% cut in their Medicare payments because of poor performance in the Physician Quality Reporting System (PQRS), the June 13 Modern Healthcare reports. The penalties are based on 2015 claims data. Though Medicare is phasing out PQRS and…

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Editor's Note Medicare payments for bariatric surgery are significantly lower at hospitals with low complication rates, and cost savings are most prominent in patients at highest risk for complications, this study finds. The analysis of 38,374 bariatric surgery patients found a strong correlation between complication rates and episode payments−hospitals in…

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Editor's Note Hospital participation in value-based reforms was associated with greater reductions in 30-day readmissions, this study finds. In this analysis of 2,837 hospitals between 2008 and 2015, researchers found that participation in one or more voluntary Medicare value-based reforms, which included the Meaningful Use of Electronic Health Records program,…

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Editor's Note A bipartisan group of 24 US Representatives sent a letter to Department of Health and Human Services Secretary Tom Price, MD, on May 26 asking him to use his statutory authority to move ambulatory surgery centers (ASCs) from the Consumer Price Index for All Urban Consumers (CPI-U) to…

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Editor's Note The Centers for Medicare & Medicaid Services (CMS) has issued a guide summarizing technical assistance resources available to small, underserved, and rural hospitals participating in the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model (AAPM). The guide also provides resources for quality innovation networks and…

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Editor's Note Quality improvement (QI) measures can be effective in reducing readmissions, relative to the status quo, but cost savings vary, this meta-analysis finds. In this review of 50 QI studies, interventions reduced readmissions by an average of 12.1% for heart failure patients and 6.3% among the general population. However,…

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Editor's Note The Ambulatory Surgical Center Quality and Access Act of 2017 (HR 1838/S 1001) has added new cosponsors in the US House of Representatives and was introduced in the Senate, the May 23 Ambulatory Surgery Center Association (ASCA) News Digest reports. Many of the cosponsors signed on as a…

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Studies have shown an association between reduced hospital readmission rates and programs implemented as part of the Centers for Medicare & Medicaid Services’ (CMS) Hospital Readmission Reduction Program (HRRP) to reduce healthcare costs and improve quality of care. Researchers from the University of Michigan in Ann Arbor and the RAND…

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Editor's Note Medicare’s Nonpayment Program of 2008, which withholds hospital reimbursement for costs related to hospital-acquired conditions (HACs), was associated with a declined in the incidence of selected HACs, and the decline was greater in hospitals with a higher Medicare utilization ratio (MUR), this study finds. Of 867,584 Medicare patients…

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Editor's Note Postoperative complications add an important marginal cost to Medicare payments and lead to a substantial portion of payments to hospitals, this study finds. Analyzing Medicare data for three procedures from 2009 to 2012, payments per uncomplicated surgical procedure were $13,500 for colectomy, $12,300 for total knee arthroplasty, and…

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