Some 60% of hospitals could face penalties under new joint replacement rule
Editor's Note A new analysis by Avalere Health (Washington, DC) finds that 60% of hospitals participating in Medicare’s Comprehensive Care for Joint Replacement bundled-payment model could face penalties if they don’t reduce their costs. The average total joint costs around $13,000, but the entire episode-of-care costs twice that at $26,000.…
Readmission reduction program has mixed results
Editor's Note A readmission reduction program for high-risk Medicare patients lowered 30-day readmission rates, but the effect was small and did not achieve the goal set by the Centers for Medicare & Medicaid Services (CMS), this study finds. Of 10,621 patients studied, readmission rates decreased from 21.5% to 19.5% in…
Scripps Health eliminates 100 management jobs
Editor's Note San Diego-based Scripps Health announced March 21 that it will restructure its management and eliminate about 100 jobs, mostly from management and administration, in an effort to reduce operating expenses, Modern Healthcare reports. A memo to Scripps employees noted that although Scripps has enjoyed healthy operating margins and…
CMS reports drop in physicians, hospitals in ‘meaningful use’
Editor's Note The number of physicians that participated in the Centers for Medicare & Medicaid Services (CMS) “meaningful use” program dropped from 228,662 in 2014 to 226,514 in 2015, and hospital participation declined from 4,177 to 4,071, Bloomberg BNA reports. The drop in participation occurred despite repeated efforts by CMS…
Patient factors strongly predict 30-day readmissions
Editor's Note The patient’s clinical condition responsible for admission, age, comorbidities, and socioeconomic factors such as race, income, and payer status were strong predictors of readmission within 30 days in this study. The analysis included some 15 million patients at 611 hospitals from Premier healthcare alliance over a 2-year period.…
Effect of bundled payments for colectomy on hospital finances
Editor's Note In this analysis of Medicare patients undergoing colectomy at Johns Hopkins, Baltimore, payments under the Bundled Payments for Care Improvement Initiative were lower than traditional fee-for-service payments, and the proportion of patients contributing to a net negative margin increased. Of 821 patients analyzed, 33.7% contributed to an overall…
CMS given more time for final notice on ‘two-midnight’ payment cut
Editor's Note The US District Court for the District of Columbia has given the Centers for Medicare & Medicaid Services’ (CMS) another month to issue a final notice justifying cutting inpatient payments by 0.2% in conjunction with its “two-midnight” rule, The March 18 AHA News Now reports. CMS has until…
Editorial
Many new healthcare payment models have cropped up in recent years, all with an eye toward rewarding providers for quality of service. In 2013, the Centers for Medicare & Medicaid Services (CMS) started a Bundled Payment for Care Improvement (BPCI) pilot with voluntary participation from numerous US facilities. Under BPCI,…
Two hospitals face value-based payment - which one does your OR resemble?
H ealthcare trends come and go, but one that shows no signs of stopping is value-based payment. Just this year, the Centers for Medicare & Medicaid Services launched the Comprehensive Care for Joint Replace-ment (CCJR) model, which mandates bundled payment for two of the most common surgical procedures in the…
Preop scale predicts readmission after total hip
Editor's Note In this study, a new risk-stratification scale identified high-risk patients for readmission within 30 days after total hip replacement with 89.1% accuracy. Nearly 269,000 hip replacement patients from the State Inpatient Database were analyzed, and factors associated with an increased risk of readmission were used to create the…
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