Medicare

Latest Issue of OR Manager
February 2018

Editorial

Uncertainty was the defining characteristic of the healthcare industry in 2017 as regulatory changes were proposed, rejected, revised, or tabled for now. The individual insurance mandate was repealed as part of a year-end tax reform bill—a victory for an administration that favors deregulation, but also a change that is projected…

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By: Elizabeth Wood
January 19, 2018
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CMS proposes coverage change for MRI with implanted cardiac devices

Editor's Note The Centers for Medicare & Medicaid Services on January 11 issued a proposal to modify its national coverage determination for magnetic resonance imaging (MRI) to include patients who have implanted cardiac devices. Proposed changes include the expansion of coverage for patients with cardiac devices that are approved or…

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By: Judy Mathias
January 16, 2018
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CMS launches new data submission system for Quality Payment Program

Editor's Note The Centers for Medicare & Medicaid Services (CMS) announced on January 2 that physicians and other eligible clinicians participating in the Quality Payment Program can begin submitting their 2017 performance data using a new system on the Quality Payment Program website (qpp.cms.gov). The new system is an improvement…

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By: Judy Mathias
January 3, 2018
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CMS updates Hospital Compare site

Editor's Note The Centers for Medicare & Medicaid Services (CMS) announced December 21 that it updated data on its Hospital Compare website and will update the Overall Hospital Quality Star Rating using a new methodology that will give more hospitals one or five stars. CMS had postponed the release of…

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By: Judy Mathias
January 2, 2018
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Where are you on the value-based care continuum?

Healthcare providers are straddling a variety of payment models while many regulatory changes remain in flux under the Trump Administration. Although the shift from fee-for-service to value-based payment began some years ago, not everyone is on board. Opinions about bundled payments also remain mixed, despite reports of improved outcomes and…

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By: Elizabeth Wood
December 14, 2017
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ASC quality reporting deadlines moved up in 2018

On November 1, 2017, the Centers for Medicare & Medicaid Services (CMS) released its final rule for the 2018 Medicare Hospital Outpatient Prospective Payment System/ASC Payment System and Quality Reporting Programs. In summary, several ambulatory surgery center (ASC) measures (ASC-1 to ASC-14) are unaffected, except that three measures (ASC-5, -6,…

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By: Leslie Flowers
December 14, 2017
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Impact of reducing postop complications in bariatric Medicare patients

Editor's Note Hospitals with the largest reductions in serious complications after bariatric surgery had the greatest decrease in per-patient Medicare payments, this study finds. Analyzing 37,329 Medicare patients undergoing bariatric surgery from 2005 to 2006 and 2013 to 2014, researchers found a strong association between reductions in complications and decreased…

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By: Judy Mathias
December 12, 2017
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CMS finalizes changes to bundled-payment models

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on November 30 announced a final rule that cancels the mandatory hip fracture and cardiac bundled-payment models, which were to begin on January 1, 2018, and implements changes to the Comprehensive Care for Joint Replacement (CJR) Model. In the final…

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By: Judy Mathias
November 30, 2017
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November 30 is deadline to avoid EHR payment adjustment

Editor's Note November 30 is the deadline for critical access hospitals that did not achieve meaningful use for the 2016 reporting period to submit hardship forms to avoid a 2018 payment adjustment, the November 27 AHA News Now reports. Inpatient prospective payment system hospitals that did not achieve meaningful use…

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By: Judy Mathias
November 29, 2017
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EHR vendor linked to MU performance of hospitals

Editor's Note A study in the Journal of the American Medical Informatics Association found that some electronic health record (EHR) vendors consistently outperform others, the November 27 Becker’s Hospital Review reports. Epic had the highest performance on five of six meaningful use (MU) stage 2 criteria, including view, download, and…

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By: Judy Mathias
November 29, 2017
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