Impact of disability and social determinants on readmissions
Editor's Note Disability and social determinants of health influence readmission risk differently when added to the Medicare risk adjustment models for the three conditions Medicare focuses on for hospital payment, finds this study. Pneumonia patients who already had difficulties with activities of daily living (ADL) before admission were more likely…
CMS publishes final rule for MU reporting
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on November 1 published a final rule that will allow providers in the Electronic Health Record (EHR) incentive program who previously demonstrated meaningful use (MU) to report to any continuous 90-day reporting period in 2016 and 2017 rather than a…
Medicare VBP bonuses down for 2017
Editor's Note More than 1,600 hospitals will get Medicare bonuses in 2017 under the Hospital Value-Based Purchasing (VBP) program, which is about 200 fewer than last year, the November 2 Modern Healthcare reports. The results are concerning because fewer hospitals are getting bonuses and hospitals aren’t moving in the rankings,…
CMS releases final rule on OPPS/ASC rates
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on November 1 released a final rule that revises the hospital outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) payment system for CY 2017. According to the rule, hospital off-campus facilities will no longer be paid the same…
Effectiveness of PSH model in pediatric settings
Editor's Note Use of the Perioperative Surgical Home (PSH) model in patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion improved surgical outcomes, this study finds. A multidisciplinary group created evidence-based protocols for preoperative, postoperative, and postdischarge patient care. Anesthesiologist comanagement of patients also allowed a new pathway for patients…
CMS publishes final MACRA rule
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on October 14 issued a final rule with comment period for implementing provisions of the new physician payment system required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), according to the October 14 Modern Healthcare. The rule…
Medicare reimbursement rates set to rise 1.2% in 2017
Ask any group of ambulatory surgery center (ASC) administrators their greatest concern, and the most likely answer will be “reimbursement.” Specifically, they will say Medicare payments do not keep up with their costs and revenue expectations. It does not help that the rules and formulas established by the Centers for…
Survey: EHRs increase costs, reduce productivity
Editor's Note A Deloitte survey of physicians found that three out of four believe electronic health records (EHRs) increase practice costs, which outweigh any efficiency savings, and seven out of 10 say EHRs reduce their productivity, the October 3 Healthcare Informatics reports. Nearly two-thirds (62%) of respondents want EHRs to…
Variation in Medicare expenditures for surgical complications
Editor's Note In this study, substantial variation was observed across hospitals in Medicare episode payments for patients rescued from surgical complications, and higher payments were not associated with improved clinical performance. Medicare payments for patients rescued at the highest-cost hospitals were two- to threefold higher than the lowest-cost hospitals for…
Study: 7-day vs 30-day readmissions as quality indicator
Editor's Note Variation in hospital readmissions is highest on the first day and declines rapidly in the first 7 days after discharge, which suggests that most readmissions after 7 days may be due to community and household factors beyond the hospital’s control, this study finds. The analysis included hospital readmissions…
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