Government and third-party payers are pushing for value-based, rather than volume-based, models of care, yet few hospitals are moving that direction, a survey shows. The Centers for Medicare & Medicaid Services (CMS) requires that half of hospitals’ payments be value based by 2018, according to a 2016 Health Catalyst survey…

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The shift toward value-based payment has gained some momentum with the Centers for Medicare & Medicaid Services’ (CMS) July 25 announcement of a proposed cardiac bundled payment model. Under the proposal, 98 randomly selected metropolitan areas would become accountable for the cost and quality of care related to coronary artery…

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Editor's Note Analyzing data on nearly 4,500 acute-care facilities, Johns Hopkins researchers found that the hospitals with the highest rates of readmissions were more likely to show better mortality scores. Data on mortality and hospital readmissions used by the Centers for Medicare & Medicaid Services (CMS) sometime fail to tell…

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Editor's Note Patient and hospital factors were associated with readmissions after pediatric surgical procedures in this study. Factors associated with readmissions included: patients with an emergency department visit within about 1 year before surgery American Society of Anesthesiologists Class IV or greater Hispanic ethnicity late-day or holiday/weekend discharges. Most factors…

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Editor's Note The Food and Drug Administration (FDA) on August 18 approved an expanded indication for the Sapien XT and Sapien 3 transcatheter heart valves for patients with aortic stenosis. The new indication is for patients who are at intermediate risk for death or complications associated with open-heart surgery. Previously,…

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Editor's Note The Advisory Panel on Hospital Outpatient Payment (HOP) on August 22 unanimously recommended that the Centers for Medicare & Medicaid Services (CMS) remove total knees from its inpatient-only list, the Ambulatory Surgery Center Association (ASCA) reports. CMS is requesting information on the feasibility of removing total knees from…

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Editor's Note The Centers for Medicare and Medicaid Services (CMS) on August 18 announced in its FAQ guidelines that the 1-year grace period for claims using the ICD-10 code set will end October 1. Healthcare organizations will be required to use the correct degree of specificity when coding claims. Unspecified…

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Editor's Note The addition of race/ethnicity and socioeconomic status to the risk-adjusted algorithm for readmissions after total hips and knees used by the Centers for Medicare & Medicaid Services led to a relative-performance change in readmission rates of <3% of 1,194 hospitals in this study. Policy makers and payers should…

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Editor's Note This study found that hospital-acquired pressure ulcers add 44% to the cost of major surgical hospital stays, but the amount varies depending on length of stay. Using data from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases and the Medicare Patient Safety Monitoring System for 2011…

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Editor's Note Medicare Advantage plans paid hospitals 8% less for hospital services than fee-for-service Medicare in 2009 and 2012, finds this study. Researchers also found that commercial insurers paid hospitals much higher than Medicare Advantage or fee-for-service Medicare. Some of this difference is because of higher prices commercial plans pay…

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