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Health Policy
November 20, 2015

Model supports quality and care improvements for patients’ transition from surgery to recovery

In 2014, more than 400,000 Medicare beneficiaries received a hip or knee replacement, costing more than $7 billion for the hospitalizations alone. Despite the high volume of these surgeries, quality and costs of care for these hip and knee replacement surgeries still vary greatly among providers. For instance, the rate of complications, like infections or implant failures, after surgery can be more than three times higher for procedures performed at some hospitals than others....

Health Policy
November 20, 2015

In discussions and comments received as part of the 2015 White House Conference on Aging (WHCOA), researchers, practitioners and other stakeholders highlighted the lack of research focusing on elder abuse as a major barrier to creating evidence-based solutions and developing policies that promote elder justice. Despite growing awareness of elder abuse, there remain significant evidence gaps in detecting, preventing, and intervening in elder abuse.

As a follow up to the WHCOA, the National Institutes of Health (NIH) held a workshop on October 30 on “Multiple Approaches to...

Health Policy
November 13, 2015

The Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 requires the Medicare Payment Advisory Commission (MedPAC) to develop a prototype prospective payment system (PPS) spanning the post-acute care (PAC) settings, using the uniform assessment data gathered previously during the Centers for Medicare & Medicaid Services (CMS) Post-Acute Care Payment Reform Demonstration (PAC-PRD) (completed in 2011). The Act requires the Commission to submit a report by June 30, 2016, presenting an approach for a unified, cross-setting PAC payment system and, to the extent feasible,...

Health Policy
November 13, 2015

On October 6, the Centers for Medicare & Medicaid Services (CMS) released the final rule with comment for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. To keep you informed of changes to the programs and how to participate in 2015, CMS has also released three new FAQs providing clarification on how to attest to certain measures for health information exchange, patient electronic access, and other objectives that require patient action.

FAQ 12817
Question: For the Health Information Exchange objective for meaningful use in 2015
...

Health Policy
November 13, 2015

In 2016, the Centers for Medicare & Medicaid Services (CMS) will apply a negative payment adjustment to individual eligible professionals (EPs), Comprehensive Primary Care (CPC) practice sites, and group practices participating in the Physician Quality Reporting System (PQRS) group practice reporting option (GPRO) (including Accountable Care Organizations [ACOs]) that did not satisfactorily report PQRS in 2014. Individuals and groups that receive the 2016 negative payment adjustment will not receive a 2014 PQRS incentive payment.

EPs, CPC practice sites, PQRS group practices,...

Health Policy
November 7, 2015

The Centers for Medicare & Medicaid Services (CMS) issued final rules late last week detailing how the agency will pay for services provided to beneficiaries in Medicare by physicians and other health care professionals in 2016

"CMS is pleased to implement the first fee schedule since Congress acted to improve patient access by protecting physician payments from annual cuts. These rules continue to advance value-based purchasing and promote program integrity, making Medicare better for consumers, providers, and taxpayers," said CMS Acting Administrator Andy Slavitt. “We...

Health Policy
November 6, 2015

This week, the Republican party elected Paul Ryan (R-WI) as the next Speaker of the House of Representatives. Representative Ryan previously served as the Chairman of the powerful House Ways and Means Committee which has jurisdiction over Medicare policies. For that much coveted seat, the House Republican Steering Committee has chosen Representative Kevin Brady (R-TX) as the next chairman of the Ways and Means Committee. Rep. Brady beat out Representative Pat Tiberi (R-OH) who had less of a health care background. Rep. Brady was one of the key legislators who pushed forward legislation to...

Health Policy
November 6, 2015

Section 6106 of the Affordable Care Act (ACA) requires facilities to electronically submit direct care staffing information (including agency and contract staff) based on payroll and other auditable data. The data, when combined with census information, can then be used to not only report on the level of staff in each nursing home, but also to report on employee turnover and tenure, which can impact the quality of care delivered.

Therefore, the Centers for Medicare & Medicaid Services (CMS) has developed a system for facilities to submit staffing and census information –...

Health Policy
October 30, 2015

The Centers for Medicare & Medicaid Services (CMS) is tracking the progress of the National Partnership to Improve Dementia Care in Nursing Homes by reviewing publicly reported measures. The official measure of the Partnership is the percentage of long-stay nursing home residents who are receiving an antipsychotic medication, excluding those residents diagnosed with schizophrenia, Huntington's disease or Tourette’s syndrome. In the fourth quarter of 2011, 23.9% of long-stay nursing home...

Health Policy
October 30, 2015

The Centers for Medicare & Medicaid Services (CMS) proposed to revise the discharge planning requirements that hospitals, including long-term care hospitals and inpatient rehabilitation facilities, critical access hospitals, and home health agencies, must meet in order to participate in the Medicare and Medicaid programs. The proposed changes would modernize the discharge planning requirements by: bringing them into closer alignment with current practice; helping to improve patient quality of care and outcomes; and reducing avoidable complications, adverse events, and readmissions....