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…

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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.…

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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…

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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…

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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…

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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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Editor's Note Postoperative readmissions are difficult to predict when the patient is discharged, and of the information available at that time, preoperative factors are the most important, this study finds. Of nearly 240,000 surgical patients included in the analysis, 43% were orthopedic, 39% were general, and 18% were vascular. The…

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Editor's Note Since Medicare adopted its prospective payment system in 1985, many hospital executives and economists have suggested that the hospital chargemaster (list of prices for all hospital procedures and supplies) is irrelevant. However, in this study, researchers found that hospitals are systematically adjusting their charge-to-cost ratios (ie, chargemaster price…

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Editor's Note The Centers for Medicare & Medicaid Services (CMS) on September 8 announced that it will give physicians and other clinicians more options in the first year to comply with the new Medicare Access and CHIP Reauthorization Act (MACRA) quality payment program.  During 2017, providers will be able to…

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Editor's Note Hospitals that care for the oldest, sickest, and most complicated patients could suffer financially under Medicare’s Comprehensive Care for Joint Replacement (CJR) bundled payment program, this study finds. The study analyzed data from more than 23,000 Michigan patients who had hip or knee replacements at 60 hospitals in a…

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