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…
Nonhierarchical vs hierarchical modeling to measure hospital performance
Editor's Note In this study, nonhierarchical modeling to measure hospital performance frequently misclassified average-quality hospitals as low quality, and hierarchical modeling misclassified low-quality hospitals as average. At low hospital case volumes, hierarchical modeling missed 90.6% of low-quality hospitals, and nonhierarchical modeling missed 65.3%. However, 38.9% of hospitals classified as low-quality…
Effect of CJR episode of care definition on hospital performance
Editor's Note Comparing the Comprehensive Care for Joint Replacement (CJR) program’s broad definition of a patient’s episode of care (ie, initial hospitalization until 90 days after discharge) with a clinically narrow definition of an episode of care, researchers found that hospital performance was consistent no matter which definition was used.…
Association between bundled payments and quality outcomes
Editor's Note In the first 21 months of the Bundled Payments for Care Improvement (BPCI) initiative for total hips and knees, Medicare payments declined more for BPCI participating hospitals than nonparticipating hospitals, without a significant change in quality outcomes, this study finds. For the analysis, 31,700 total joints at 176…
Oct 1 deadline for EHR incentive program
Editor's Note First time participants in the Centers for Medicare & Medicaid Services (CMS) Electronic Health Records (EHR) Incentive Program must attest to meaningful use for a 90-day reporting period by October 1 to avoid a payment adjustment in 2017, the September 26 AHA News reports. Returning participants must report…
Novel model predicts readmission risk
Editor's Note A novel model by researchers from the Massachusetts General Hospital, Boston, uses natural language processing to predict readmission risk by incorporating physical function, cognitive status, and psychosocial support--three areas that may impact readmission but are poorly captured with structured data sources. The final model had 16 variables, a…
CMS: Readmissions fall by more than 500,000
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on September 13 announced that 30-day patient readmissions fell by an estimated 565,000 over 5 years, from 2010 to 2015. Rates declined by more than 5% in 43 states and by more than 10% in 11 states. The only state…
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