Build a strong anesthesia quality program to boost patient safety and the bottom line
Quality indicators for anesthesia For the past several years, physicians have participated in the Physician Quality Reporting System (PQRS) established by Medicare as a way to assess the quality of patient care and tie that to reimbursement. Beginning in 2015, a negative payment adjustment hit individuals and group practices whose…
Disaster planning exercises prepare ASCs to care for patients and assist communities
Ambulatory surgery centers (ASCs) are taking a new look at the question of disaster response. Staff are not always informed about what emergencies might occur, or what they should do in response to the most likely scenarios. Likewise, many local emergency management agencies are not even aware of the ASCs…
CMS finalizes rule for hip and knee bundled payments
Editor's Note The Centers for Medicare and Medicaid Services (CMS) has finalized the rule that will require hospitals in 67 geographic areas to participate in a test of bundled payments for hip and knee replacements, Modern Healthcare reports. Medicare's average bundled payment ranges from $16,500 to $33,000 for surgery, hospitalization,…
Medical societies plead with Congress to fix ‘meaningful use’
Editor's Note A coalition of 111 medical societies on November 4 sent letters asking Senate and House leaders to take legislative action to pause Stage 3 of the electronic health records meaningful use program and revise Stage 2 so that it enables provider success, HealthData Management reports. Stage 3 requirements…
CMS denies 10% of claims under new ICD-10 codes
Editor's Note The Centers for Medicare & Medicaid Services (CMS) rejection rate of Medicare fee-for-service claims submitted with the new ICD-10 codes was 10.1% in October. Invalid use of ICD-9 codes resulted in the rejection of 0.11%, and 2% were not accepted because of invalid or incomplete information. More information…
Medicare releases 2016 final ASC payment rule
Editor's Note On October 30, the Centers for Medicare & Medicaid Services (CMS) released the final 2016 payment rule for ambulatory surgery centers (ASCs). ASC payment rates will increase by 0.3%, which is based on a projected inflation rate of 0.8% minus a 0.5% productivity adjustment required by the Affordable…
CMS finalizes 2016 payment rules for physicians, hospitals
Editor's Note The Centers for Medicare & Medicaid Services (CMS) has issued its final rules detailing how it will pay for services provided by physicians and other healthcare professionals in 2016. Key policies finalized in the rules include: Updates to the “Two-Midnight” rule, which clarifies when inpatient admissions are appropriate…
Hospitals with high readmission rates penalized for the patients they serve
Clinical and social characteristics not included in Medicare’s current risk-adjustment methods explained much of the difference in readmission risk between patients admitted to hospitals with higher versus lower readmission rates, a study finds. The Medicare Hospital Readmissions Reduction Program penalizes hospitals with higher than expected 30-day readmission rates by reducing…
SSI risk after c-section twice as high for Medicaid patients
Editor's Note Medicaid patients had a twofold higher risk of surgical site infections (SSIs) after cesarean delivery than privately insured patients, this study finds. The higher risk remained even after adjusting for demographic and clinical variables. Medicaid might represent factors the study did not account for, such as socioeconomic status…
Validity of CAUTI metric used for value-based purchasing questioned
Editor's Note Two different measurement systems are used to track performance in lowering the rate of catheter-associated urinary tract infections (CAUTIs). The Agency for Healthcare Research and Quality metric has shown a 28.2% decrease in CAUTIs since 2010, whereas the Centers for Disease Control and Prevention’s metric has shown a…
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