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Latest Issue of OR Manager
October 2019

Effect of ‘regression to the mean’ on excess readmissions

Editor's Note Strong evidence suggests that most declines in excess readmissions--after implementation of Medicare’s Hospital Readmission Reduction Program (HRRP)--at poorly performing hospitals can be explained by a statistical phenomenon called “regression to the mean [RTM],” this study finds. In RTM, entities farther away from the mean in one period are…

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By: Judy Mathias
September 4, 2019
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ASC Manager Issue 2

Healthcare providers have seen a steady stream of inpatient-only procedures migrate to ambulatory surgery centers (ASCs) over the past few years. Medicare is reimbursing an increasing number of procedures performed in the outpatient setting, many of them cardiovascular in nature. This issue of ASC Manager explores the development of a…

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By: Judy Mathias
August 23, 2019
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CMS to enhance Overall Hospital Quality Star Ratings

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on August 19 announced that it plans to update the quality measurement methodology of the Overall Hospital Quality Star Ratings in 2021. The Star Ratings are located on CMS’ Hospital Compare website. While the new methodology is being finalized, CMS…

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By: Judy Mathias
August 19, 2019
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Joint Commission refines requirements for practitioner credentialing, privileging, and evaluation

Editor's Note The Joint Commission announced on August 14 that accredited hospitals and critical access hospitals will be able to supplement local data with data acquired from Medicare-certified hospitals and critical access hospitals for the purposes of practitioner credentialing, privileging, and evaluation (focused and ongoing). The supplemental data may not…

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By: Judy Mathias
August 15, 2019
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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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