IPRO has been chosen by the State of New York to examine utilization of the state’s Early Intervention (EI) program, which provides therapeutic and supportive services to children with disabilities, age birth through two years, and their families. Under the program, all eligible children receive multidisciplinary evaluations, including assessment of cognition and communication as well… Continue Reading
IPRO Earns Appeals Accreditation
IPRO has earned accreditation as an Independent Review Organization (IRO) by the nationally recognized URAC organization. IROs conduct impartial, independent reviews of appeals of health plan decisions lodged by patients and their representatives or providers. IPRO currently conducts these reviews in 16 states and the District of Columbia. “We are grateful for this honor,” notes… Continue Reading
Surgical Care Improvement Project Addresses Patient Safety
Hospital-acquired infections remain the cause of extended hospitalizations, and even death, for thousands of patients nationwide every year. They merit every hospital’s attention and effort. A range of healthcare organizations have coalesced around this issue in an effort to improve patient safety by reducing post-surgical complications. Ten national healthcare organizations are spearheading the effort, including… Continue Reading
Statewide Effort Seeks to Reduce MRSA Risk
According to a 2007 article in JAMA, methicillin-resistant Staphylococcus aureus (MRSA) causes approximately 94,000 serious infections and 19,000 deaths in the United States each year. Of these, 86% are health care associated and 14% are community associated. The Centers for Disease Control and Prevention (CDC) reports that MRSA infection as a proportion of all staph… Continue Reading
Many Hospital Readmissions May Be Prevented Through Improved Care Transitions
A study published in the New England Journal of Medicine last year found that nearly one fifth of Medicare beneficiaries discharged from a hospital were rehospitalized within 30 days, and 34 percent were rehospitalized within 90 days. A 2005 analysis by the federal Medicare Payment Advisory Commission (MedPAC) concluded that as many as three out… Continue Reading
Administration Implements Appeals Law
Health plan enrollees have the right to independent, external reviews of adverse coverage determinations, regardless of which state the live in or what kind of insurance they have, based on an interim final rule published July 23rd in the Federal Register. The rule implements provisions of the Patient Protection and Affordable Care Act. It applies… Continue Reading
CMS Develops Payment Plans for ESRD
The Centers for Medicare & Medicaid Services (CMS) is developing what it calls the first Medicare fee-for-service pay-for-performance program, under which end-stage renal disease (ESRD) providers face the prospect of reduced payments for failure to meet quality benchmarks. Under the Medicare Improvements for Patients and Providers Act of 2008, CMS is required to develop a… Continue Reading
New York Hospitals Pilot Malpractice Reform
Five New York City-based hospitals will test an innovative approach to medical liability reform under a three year, $2.9 million grant from the federal Agency for Healthcare Research and Quality (AHRQ). The participating hospitals are Beth Israel Medical Center, Maimonides Medical Center, Montefiore Medical Center, Mount Sinai Medical Center and New York Presbyterian Hospital. Under… Continue Reading
White House Estimates Quality Savings
Improvements in quality are essential elements of a national cost-containment strategy, according to a health reform position paper released August 2nd by the Obama Administration. Quality enhancements included in the Affordable Care Act are projected to account for a ten-year cost savings of $15 billion. The key quality-related provisions are: reducing hospital readmissions ($8.2 billion),… Continue Reading
Commonwealth Publishes Infection Rates
The Commonwealth Fund’s landmark www.WhyNotTheBest.org website now includes information on the incidence of central-line-associated bloodstream infections (CLABSIs) in intensive care units in hospitals nationwide. These preventable infections occur when catheters are placed in large veins to speed administration of fluids. Experts estimate a mortality rate of between 12% and 25% for each infection, of which… Continue Reading