HCAHPS: How the OR's scores affect your whole organization
Fiscal year 2013 will be a milestone for hospital reimbursement. That's the year Medicare's proposed new hospital value-based purchasing program starts. Under value-based purchasing, a portion of hospitals' DRG reimbursement will be based on their performance on quality metrics, including patient perceptions of the quality of care (PPQC). (See March…
90-day guarantee: Warranties as a tool for improved patient outcomes
Everything from washers to cars comes with a warranty, so why not health care? Geisinger Health System in Danville, Pennsylvania, introduced health care warranties with an innovative program called ProvenCare. Under the 90-day warranty, one cost covers the surgery and 90 days of follow-up treatment. Geisinger absorbs any additional costs…
More surgical infections on no-pay list
Three more preventable conditions have been added to the list of those Medicare will no longer pay extra for in hospitals in fiscal year 2009, which starts Oct 1, 2008. Medicare also added 13 quality measures for a total of 42 that will need to be reported for a full…
P4P: Building a culture of quality and bringing costs of care down
Pay-for-performance—it's a term you'll hear more about. Medicare officials think pay-for-performance (P4P) could encourage hospitals to improve quality while bringing costs down—a priority given that the hospital trust fund is projected to run out of money in 11 years. Congress has asked Medicare to come up with a plan that…
Aetna to stop covering MAC for GI endoscopy cases
Aetna informed physicians in December that it will no longer pay for monitored anesthesia care (MAC) for routine GI endoscopy as of April 1. Aetna joins others, including WellPoint, Inc, the nation's largest health insurer, that no longer cover anesthesia monitoring for these procedures. MAC can add $300 to $1,500…
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