CMS

Latest Issue of OR Manager
March 2020

Study challenges concerns about HRRP

Editor's Note This study from the division of cardiology at Dallas’ University of Texas Southwestern Medical Center and the Yale School of Medicine, New Haven, Connecticut, challenges concerns about Medicare’s Hospital Readmission Reduction Program (HRRP)--ie, that it leaves patients more vulnerable and increases postdischarge mortality rates. Analyzing inpatient and outpatient…

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By: Judy Mathias
January 16, 2020
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CMS expects greater scrutiny from Joint Commission surveyors

The start of a new year includes OR Manager’s annual updates on Joint Commission standards—an effort to help OR leaders ensure their facilities are in compliance. With increasingly stringent expectations from the Centers for Medicare & Medicaid Services (CMS), the Joint Commission and other accreditation organizations are under pressure to…

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By: OR Manager
December 17, 2019
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To avoid penalties, know the rules for quality reporting

Keeping up with Medicare’s regulatory and reporting requirements for ambulatory surgery centers (ASCs) can be as difficult as ensuring physicians arrive to start their cases on time. “Regulations can change frequently,” says Gina Throneberry, MBA, RN, CASC, CNOR, director of education and clinical affairs for the Ambulatory Surgery Center Association…

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By: OR Manager
December 17, 2019
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Hospital-based care coordination strategies linked to CMS star ratings

Editor's Note Care coordination strategies were found to be associated with high overall hospital quality star ratings from the Centers for Medicare & Medicaid Services (CMS) in this study. A total of 710 general acute care noncritical access hospitals that received star ratings and responded to the 2015 American Hospital…

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By: Judy Mathias
November 21, 2019
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A primer for starting a total joint replacement program

Ambulatory surgery centers (ASCs) have increasing incentives to offer total joint replacements (TJR) as Medicare expands the list of covered procedures. However, there’s a lot to consider in this particular service line. “There are many things to arrange that aren’t required with other service lines, particularly as home care of…

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By: OR Manager
November 18, 2019
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Improving prediction of adverse surgical outcomes with machine learning algorithm

Editor's Note In this study, a new machine learning Complexity Score algorithm outperformed three commonly used risk scores in predicting postoperative morbidity, 30-day readmission, 90-day readmission, and postoperative surper-use. Study patients underwent colectomy, abdominal aortic aneurysm repair, coronary artery bypass grafting, total hip or knee replacement, or lung resection. The…

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By: Judy Mathias
November 6, 2019
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CMS releases 2020 final payment rule for ASCs, HOPDs

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on November 1 released its final payment rule for ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs). CMS added eight codes to the ASC-payable list, including total knee arthroplasty. CMS also removed total hip arthroplasty and seven spine codes from…

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By: Judy Mathias
November 4, 2019
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CMS proposes to revise physician anti-kickback rules

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on October 9 announced proposed changes to how it enforces the Physician Self-Referral Law (ie, Stark Law), which penalizes physicians and other healthcare providers for referring patients to outside services they could stand to benefit from financially. The proposed rule…

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By: Judy Mathias
October 10, 2019
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Joint Commission reviewing CMS final rules on discharge planning, burden reduction

Editor's Note The Joint Commission announced on October 9 that it is reviewing discharge planning and burden reduction changes announced in the Centers for Medicare & Medicaid Services’ (CMS) final rules published September 30. Any changes to Joint Commission accreditation requirements for deemed programs will go through the CMS iterative…

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By: Judy Mathias
October 10, 2019
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CMS: New round of readmission penalties affects 2,583 hospitals

Editor's Note Data from the Affordable Care Act’s Hospital Readmissions Reduction Program (HRRP) shows that Medicare cut payments to 2,583 hospitals on October 1 because of the number of patients readmitted within a month, the October 1 Kaiser Health News reports. The Centers for Medicare & Medicaid Services (CMS) estimates…

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By: Judy Mathias
October 2, 2019
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