Deadline looms for CMS orthopedic bundled care program
Only a few months remain before the Comprehensive Care for Joint Replacement (CCJR) goes into effect on January 1, 2016. This orthopedic bundled program, mandated by the Centers for Medicare & Medicaid Services (CMS), is expected to save $153 million as part of the goal to convert 50% of Medicare…
Most Medicare ACOs received no bonuses in 2014
Editor's Note Only 97 of 353 Medicare accountable care organizations (ACOs) met targets for quality and slowed spending enough to earn bonuses in 2014, Modern Healthcare reports. This is a continuation of mixed results for the ACO initiative that the Obama administration has targeted for rapid expansion through 2018. The…
CMS announces additional participants for bundled payment initiative
Editor's Note The Centers for Medicare & Medicaid Services announced on August 13 that 360 more organizations have entered into agreements to assume financial risk for an episode of care during the second phase of the Bundled Payments for Care Improvement Initiative. The initiative is testing four bundled payment models…
Editorial
The French proverb, “the more things change, the more they stay the same,” is one way to view the readmission penalties imposed by the Centers for Medicare & Medicaid Services (CMS). About a year ago, a Kaiser Health News report said more than 2,600 hospitals in fiscal year 2015 were…
Quality reports to determine pay rise or fall
Ambulatory surgery centers (ASCs) that have yet to register and report compliance with quality measures can expect a decrease of 0.9% in 2016 from this year’s Medicare reimbursement rates. Those in compliance, however, may see an increase of approximately 1.1%, depending on specialties. As in the past, the Centers for…
CMS extends “Two-Midnight” rule partial enforcement delay to end of year
Editor's Note The Centers for Medicare & Medicaid Services on August 12 extended the partial enforcement delay of the “Two-Midnight” rule from September 30 to December 31, AHA News reports. The extension prohibits Recovery Audit Contractors from conducing post-payment patient status reviews for claims with admission dates October 1 to…
Variation in surgical readmissions mostly patient related
Editor's Note Postoperative readmissions occurred in more than 1 in 10 patients, in this study, with considerable variation across specialties. The majority of variation was attributable to patient-related factors (82.8%); surgical specialty accounted for 14.5% of the variability, and individual surgeon factors accounted for 2.8%. After adjusting for patient and…
US Senate passes Electronic Health Fairness Act
Editor's Note The US Senate on August 5 passed the Electronic Health Fairness Act of 2015 (S 1347), which was heavily promoted by the Ambulatory Surgery Center Association. The legislation protects physicians practicing in ASCs from Medicare meaningful use penalties until a certified electronic health record technology is available for…
CMS extends ASC quality measure deadline until September 30
Editor's Note The Centers for Medicare & Medicaid Services has extended the deadline for submitting data for the Ambulatory Surgical Center Quality Reporting Program until September 30, the Ambulatory Surgery Center Association reports. This applies to the claims-based measures submitted via QualityNet and the Centers for Disease Control and…
Medicare penalizes more than half of hospitals for readmissions
Editor's Note Nearly 2,600 hospitals will be penalized for missing readmission targets under Medicare, with a loss of $420 million, Kaiser Health News reports. The average Medicare payment reduction is 0.61% per patient stay; 38 hospitals will receive the maximum cut of 3%. The reductions are based on readmissions of…
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