Medicare

Latest Issue of OR Manager
August 2019

Hospital revisits have increased since implementation of HRRP

Editor's Note Hospital revisits (ie, treat-and-discharge visits to ED, observation stays, or inpatient readmissions) within 30 days of discharge have increased since implementation of the Hospital Readmission Reduction Program (HRRP), this study finds. Though hospital readmissions have dropped since HRRP was implemented as part of the Affordable Care Act, there…

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By: Judy Mathias
August 14, 2019
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CMS proposes giving Medicare patients better access to cutting-edge devices

Editor's Note In its proposed rule, the Centers for Medicare & Medicaid Services (CMS) would give Medicare patients better access to innovative devices beginning next year, the July 30 MassDevice reports. CMS also says it might pay more for “certain transformative new devices” for inpatients, using a new technology add-on…

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By: Judy Mathias
August 1, 2019
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CMS maintains site-neutral cuts in 2020 proposed rule

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on July 29 issued the 2020 proposed payment rule for ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs), which would increase Medicare hospital outpatient prospective payment system rates by 2.7%. CMS is also proposing to add eight codes to…

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By: Judy Mathias
July 31, 2019
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Changes in hospital referral patterns to skilled nursing facilities under HRRP

Editor's Note The Hospital Readmission Reduction Program (HRRP), which penalizes hospitals for higher-than-expected readmission rates, did not prompt substantial changes in hospital referral patterns to skilled nursing facilities (SNFs), this study finds. However, readmissions for patients referred to SNFs decreased more than for other patients. In this analysis of nearly…

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By: Judy Mathias
July 24, 2019
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Hospital network participation not linked with improved outcomes, lower costs

Editor's Note Hospital network participation was not associated with improvements in surgical outcomes or Medicare expenditures, compared with hospitals not in a network, this study finds. In this analysis of nearly 2 million Medicare beneficiaries having general, vascular, cardiac, or orthopedic surgery between 2007 and 2014 at network (1,868) or…

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By: Judy Mathias
July 16, 2019
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Disadvantaged neighborhoods linked to higher readmission rates

Editor's Note Residing in a disadvantaged neighborhood in Maryland and being discharged from a hospital serving a large proportion of disadvantaged neighborhoods were independently associated with increased risk of readmission in this study. 2015 data from Maryland hospitals showed a 14.1% 30-day readmission rate for patients living in neighborhoods in…

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By: Judy Mathias
July 11, 2019
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CMS penalty program not linked to hospital safety improvements

Editor's Note The Centers for Medicare and Medicaid Services (CMS) hospital penalization in the Hospital Acquired Condition Reduction Program (HACRP) was not associated with significant changes in rates of hospital acquired conditions (HACs), 30-day readmissions, or 30-day mortality and does not appear to drive meaningful clinical improvements, this study finds.…

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By: Judy Mathias
July 11, 2019
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CMS finalizes coverage policy for TAVR

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on June 21 issued final updates to its national coverage policy for Transcatheter Aortic Valve Replacement (TAVR). The update provides more flexibility in how centers meet volume requirements for performing TAVR, while emphasizing the importance of the heart team for…

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By: Judy Mathias
June 26, 2019
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CMS selects ECRI Institute for NQIIC designation

Editor's Note The ECRI Institute on June 20 announced that the Centers for Medicare & Medicaid Services (CMS) had awarded it with the Network of Quality Improvement and Innovation Contractors (NQIIC) designation. With this designation and partnering with other quality improvement contractors under the new CMS Indefinite Delivery/Indefinite Quanity (IDIQ)…

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By: Judy Mathias
June 24, 2019
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Editorial

The Leapfrog Group’s spring 2019 Hospital Safety Grade Report shows some progress in patient safety: an estimated 160,000 avoidable deaths nationwide, down from 205,000 in 2016. But 160,000 is a large number. “There’s still a lot of needless death and harm in American hospitals,” says Leah Binder, Leapfrog’s president and…

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By: Elizabeth Wood
June 18, 2019
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