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Quality

 

The establishment of a primary care-led regional health improvement collaboration in the Cleveland area reduced hospitalizations attributed to conditions like heart failure and bacterial pneumonia, saving nearly $40 million, according to a study published in the February 2017 issue of Health Affairs.

In a single year, more than 600,000 patients in Washington state received services that would be considered low value or wasteful, resulting in $282 million in unnecessary healthcare spending.

A five-star rating on CMS’s Nursing Home Compare website may not equate to “five-star service,” according to a Florida Atlantic University (FAU) study that found nursing homes’ scores may be artificially inflated.

A study from the Medicare Payment Advisory Commission (MedPAC) found the Hospital Readmissions Reduction Program (HRRP) has largely achieved its goals—and contrary to the findings of an earlier study, it didn’t increase mortality rates.

Hospitals accredited by the Joint Commission which offer services for labor and delivery will have three new documentation elements of performance (EPs) beginning on July 1.

 

Recent Headlines

Mayo Clinic repeats as No. 1 hospital on U.S. News & World Report rankings

The 2017-18 U.S. News and World Report best hospitals list once again has the Mayo Clinic sitting on top, with Cleveland Clinic remaining No. 2 while Massachusetts General Hospital, No. 1 in 2015-16, fell to fourth place behind Baltimore’s Johns Hopkins Hospital.

Expensive exams benefiting medical boards

Nonprofit medical boards reported a $23 million surplus in 2013, more than triple what was recorded a decade earlier. Most of that revenue comes from charging physicians for certification exams.

U.S. News hospital rankings delayed due to data errors

The annual hospital rankings from U.S. News and World Report will now be released a week later than scheduled after errors were discovered in data which affected 12 “data-driven specialty rankings.”

Fake clinics, unnecessary opioid prescriptions involved in $1.3B fraud crackdown

The U.S. Department of Justice charged 412 people, including 56 doctors, for allegedly participated in false billing schemes netting $1.3 billion, with many cases involving prescriptions of opioids or other narcotics.

Hospitals strongly oppose CMS move to make AO reports public

CMS has proposed requiring private accrediting organizations (AOs), like the Joint Commission, to publicly release what have been confidential survey reports of hospitals. Dozens of AOs and the facilities they inspect asked the agency to take that change out of the final Medicare Inpatient Prospective Payment System (IPPS) rule for 2018, arguing the reports shouldn’t be treated like healthcare quality data.

ACA plans likely to exclude top cancer hospitals

Coverage on the Affordable Care Act (ACA) insurance exchanges, where narrow network plans are dominant, is more likely to exclude doctors associated with National Cancer Institute (NCI)-designated cancer centers, according to a new study published in the Journal of Clinical Oncology.

Two-thirds of patients haven’t completed advance directives for end-of-life care

Advance directives, like awarding power of attorney on health care decisions or completing a living will, haven’t been completed by most patients, including those with chronic illnesses, potentially complicating decisions by hospitals and physicians on end-of-life treatment.

HFMA 2017: LexisNexis’ Rick Ingraham on using social determinants for ‘proactive patient outreach’

Addressing social determinants of health has been labeled a priority by many studies and healthcare organizations, but that data can also be used by health plans to assess a member’s future risk.

HFMA 2017: How Yale New Haven Health found ‘improved quality means improved margin’

The shift from volume to value isn’t an easy transition for healthcare, but data can make all the difference, especially for a large system which often takes in complex patients from other facilities, which was the case for Yale New Haven Health System.

Racial disparity in surgical readmissions greater among Medicare Advantage patients

Black surgical patients in both traditional Medicare and Medicare Advantage (MA) were more likely than white patients to be readmitted to the hospital within 30 days, but for MA beneficiaries, the racial disparity was much greater.

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