Spending for the major government healthcare programs will rise by $55 billion, or about 6 percent, in 2016, and Medicare will account for more than half of that increase, according to budget projections from the Congressional Budget Office.
A year after paying nearly $1.5 billion to more than a third of U.S. hospitals to resolve longstanding Medicare billing disputes, the Obama administration has disclosed who got paid.
NewYork-Presbyterian Hospital, one of the nation’s largest academic medical centers, received nearly $16 million, more than any other hospital, according to data released by the Centers for Medicare & Medicaid Services.
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 on Wednesday, slapping average or below average scores on many of the nation’s best-known hospitals while awarding top scores to dozens of unheralded ones.
The Centers for Medicare & Medicaid Services rated 3,617 hospitals on a one- to five-star scale, angering the hospital industry, which has been pressing the Obama administration and Congress to block the ratings. Hospitals argue the ratings will make places that treat the toughest cases look bad, but Medicare has held firm, saying that consumers need a simple way to objectively gauge quality.
Data Brief: Evaluation of National Distributions of Overall Hospital Quality Star Ratings
Hospital Compare is a consumer-oriented website that provides information on how well hospitals provide care to their patients. This information can help consumers make informed decisions about their health care. The Centers for Medicare & Medicaid Services (CMS) has been posting quarterly hospital quality star ratings based on patients’ experience of care on the Hospital Compare website since April 16, 2015.
To continue our efforts to make quality of care information more readily available, we developed an Overall Hospital Quality Star Rating (Star Rating) that reflects comprehensive quality information about the care provided at our nation’s hospitals. We have previously stated our intention to begin posting this overall star rating on Hospital Compare in 2016, which we expect to begin shortly.
CMS issues data on national distribution of overall hospital star ratings
by AHA News Now
The Centers for Medicare & Medicaid Services today released data on the national distribution of overall hospital quality star ratings and by hospital characteristics, including bed size, teaching status, safety-net status, eligibility for Disproportionate Share Hospital payments and critical access hospital status. The agency said it intends to post the ratings for individual hospitals shortly. Earlier this month, the AHA, Association of American Medical Colleges, America’s Essential Hospitals, and Federation of American Hospitals urged CMS to share additional information with hospitals and the public about how accurately its overall hospital quality star ratings portray hospital performance, and to work with hospitals to validate the methodology or continue to withhold publication of the ratings. As many as 225 members of the House of Representatives and 60 senators also urged CMS to delay the April 21 release of the ratings “to provide the necessary time to more closely examine the star rating methodology, analyze its impact on different types of hospitals, and provide more transparent information regarding the calculation of the ratings to determine accuracy.”
New Health System Scorecard Finds Improvement in Most U.S. Communities Since ACA Took Effect
by The Commonwealth Fund
Many U.S. communities saw gains in their health and health care between 2011 and 2014, but wide variation in progress indicates there is room for improvement across the country, The Commonwealth Fund’s newly updated Scorecard on Local Health System Performance finds.
Those areas of the U.S. that improved did so largely because more people had insurance coverage and could afford to get the care they needed, and because health care providers performed better on quality and efficiency measures—such as limiting hospital readmissions. The Affordable Care Act (ACA) has contributed to many of these improvements, the researchers say.
Analysis Finds End-of-Life Medicare Spending Declines With Age Among Seniors
by Kaiser Health News
Among beneficiaries who died in 2014, Medicare spent significantly more per person on medical services for seniors in their late sixties and early seventies than on older beneficiaries, according to a new data note from the Kaiser Family Foundation. The analysis comes at a time when physicians can now be reimbursed by Medicare for end-of-life care discussions with their patients.
U.S. Car Crash Deaths Down, But Still Surpass Other Nations
Decline of 31 percent lowest among 20 countries studied
Car crash deaths on American roads fell nearly one-third over a recent 14-year period, but the nation's collision death rate still tops that of other high-income countries, health officials reported Wednesday.
About 90 Americans die in crashes every day. That's the highest roadway death rate among 20 countries examined, the U.S. Centers for Disease Control and Prevention said.
The Centers for Medicare & Medicaid Services today proposed to update hospital outpatient prospective payment system rates by 1.55% in calendar year 2017 compared to CY 2016. The rule also proposes to implement the site-neutral provisions of Section 603 of the Bipartisan Budget Act of 2015, which requires that, with the exception of dedicated emergency department services, services furnished in off-campus provider-based departments that began billing under the OPPS on or after Nov. 2, 2015 would no longer be paid under the OPPS; instead these services would be paid under other applicable Part B payment systems beginning Jan. 1, 2017.
Now that ICD-10 is in full swing, we are seeing a lot of activity with providers, payers, consultants and regulators who need to understand how Acute Inpatient and Long Term Care Hospital claims "behave" when the claim is coded in ICD-10. This includes both prospective and retrospective review of claims scenarios to understand MS-DRG grouping. This article offers a basic primer on MS-DRG grouping logic, and research techniques for using related MediRegs Coding Suite tools. If you'd like a personalized training on these tools, or a demonstration of them in action to see if they are a good fit for your research scenarios, please let us know!
OVERVIEW OF THE FY 2016 IPPS FINAL RULE: SUMMARY OF CALCULATION ELEMENTS
New Health Analytics, a national healthcare software developer and data analytics firm, is pleased to announce that it has released a special report with an concise review of the FY 2016 Hospital Inpatient Prospective Payment System (IPPS) Final Rule recently posted by the Centers for Medicare & Medicaid Services.