Medicare’s Readmission Penalties Hit New High
By Jordan Rau – The federal government’s readmission penalties on hospitals will reach a new high as Medicare withholds more than half a billion dollars in payments over the next year.
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Many Well-Known Hospitals Fail To Score 5 Stars In Medicare’s New Ratings
By Jordan Rau – The federal government released its first overall hospital quality rating recently, slapping average or below average scores on many of the nation’s best-known hospitals while awarding top scores to dozens of unheralded ones. CMS rated 3,617 hospitals on a one- to five-star scale, angering the hospital industry.
Hospital IPPS and LTCH Final Rule Policy and Payment Changes for Fiscal Year 2017
CMS issued a final rule to update fiscal year 2017 Medicare payment policies and rates under the Inpatient Prospective Payment System and the Long-Term Care Hospital Prospective Payment System. The final rule, which would apply to approximately 3,330 acute care hospitals and approximately 430 LTCHs, would affect discharges occurring on or after October 1, 2016.
Survey Says Fewer Than 2 in 10 Hospitals Regularly Use Patient-Reported Outcomes
72% of hospitals with limited or no Patient-Reported Outcomes Tracking say they will implement it within 1-3 years. CMS recently began using a new yardstick to calculate how much providers should be paid: a patient’s own view of their health. First incorporated into a new CMS program designed to lower the cost of knee and hip replacements, patient-reported outcomes, or PROs, may soon become far more widespread.
Medicare Policy Changes in 2016: What You Need to Know
By Kim Straub – Here’s what you need to know and how you can adjust to the new payment policies. The Two-Midnight Rule – The changes to this rule came into effect in January this year. The Two Midnight Rule, founded in 2013, helps define inpatient versus out-patient stays, but does so in a way that can make patient intake awkward.
Medicare Announces Participants for a New Initiative to Prevent Heart Attacks and Strokes
The Centers for Medicare & Medicaid Services announced 516 awardees in 47 states, Puerto Rico, and the District of Columbia to help reduce the risks…
CMS Proposes Changes to the Medicare and Medicaid EHR Incentive Programs
On July 6, CMS released the Calendar Year (CY) 2017 Changes to the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) proposed rule. This rule includes a number of proposed changes that would affect the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs.
Physician Fee Schedule: Proposed CY 2017 Changes
On July 7, CMS proposed changes to the Physician Fee Schedule to transform how Medicare pays for primary care through a new focus on care management and behavioral health designed to recognize the importance of the primary care work physicians perform. The rule also proposes policies to expand the Diabetes Prevention Program within Medicare starting January 1, 2018.
Fraud Takedown: Same Old Song, Expanding Dance
By Matt Fisher – It seems as though multiple times per year the Department of Justice, HHS, or some other enforcement agency announces the largest sweep or takedown of health care related fraud. A joint Department of Justice and HHS announcement on June 22, 2016 is the latest example.