Qualified non-governmental organizations will be able to publish physician-specific Medicare performance information beginning in 2012, so long as they combine that data with other claims information, according to a final rule issued December 5 by the Centers for Medicare & Medicaid Services (CMS). Under the terms of the final rule, qualified entities can publish Medicare… Continue Reading
Government Revamps Quality Rules
While adding requirements for hospitals, the new “Conditions of Participation” issued by the Centers for Medicare & Medicaid Services (CMS) will actually save more than $900 million annually in administrative efficiencies, according to senior managers at the agency. “Conditions of Participation” are the quality and safety standards that government survey teams and private accreditation agencies… Continue Reading
NY Workgroup Offers Medicaid Reform Package
The Payment Reform and Quality Measurement Work Group of New York’s Medicaid Redesign Team released its final recommendations in December. Chaired by Dan Sisto, President of the Healthcare Association of New York State, and William Streck, MD, Chair of the New York State Public Health and Health Planning Council, the 21-member Work Group agreed on… Continue Reading
Feds Publish Medicaid Quality Measures
The U.S. Department of Health & Human Services has published an initial core set of 26 quality measures for states to use in evaluating the performance of Medicaid programs, applicable to both managed care and fee-for-service providers. As mandated by the Affordable Care Act, HHS was charged with developing a uniform set of performance measures… Continue Reading
CMS Names 73 “Innovation Advisors”
Seven New Yorkers are among the first group of “Innovation Advisors” selected by the U.S. Centers for Medicare & Medicaid Services (CMS) to test new models of healthcare delivery. CMS announced the first 73 individuals chosen to participate in the program in December 2011; the agency plans to select as many as 200 Advisors during… Continue Reading
IPRO Supports Chronic Care Quality Evaluation
New York is ahead of other states in developing quality measures for poor and elderly residents with multiple chronic conditions, by virtue of early work done by the New York State Department of Health and IPRO. That’s a finding included in a new report from the United Hospital Fund that examines the need for measures… Continue Reading
IPRO Authors Analyze Medication Reconciliation
A systems-based approach to medication reconciliation can support substantial reductions in hospital readmission rates, a reduced risk of adverse drug events and more costeffective service delivery, according to a new journal article by authors at IPRO’s Albany NY office, and at Seton Home Health Care and Seton Health/St. Mary’s Hospital in Troy NY. Scheduled for… Continue Reading
Online Publisher Assesses Hospital Quality
Nearly a quarter of a million U.S. lives could have been saved over a recent three-year period if all Medicare patients were treated in the highest-performing hospitals, according to a new report from HealthGrades, the online healthcare publisher. HealthGrades argues that 240,040 Medicare patient lives could have been saved from 2008 to 2010 had hospitalizations… Continue Reading
Kaiser Foundation Examines Managed Care
The vast majority of states with Medicaid managed care plans (MCOs) now produce public reports on quality, according to a comprehensive survey just out from the Kaiser Commission on Medicaid and the Uninsured. Over three-fourths of the 36 states with MCOs publish quality reports, with 16 now producing actual “report cards.” All states with MCOs… Continue Reading
Feds Issue Final Shared Savings Regulation
The final federal language implementing a key Medicare shared savings initiative includes substantial changes that ought to increase provider participation in the program. That’s according to an article by CMS Administrator Donald M. Berwick, MD that appeared in the October 26 New England Journal of Medicine. Under the Accountable Care Organization (ACO) model mandated by… Continue Reading