CMS PROPOSALS TO IMPROVE QUALITY OF CARE DURING HOSPITAL INPATIENT STAYS
On Apr. 26, 2013, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospitals Prospective Payment System (LTCH PPS) in Fiscal Year (FY) 2014.
The proposed rule, which would apply to approximately 3,400 acute care hospitals and approximately 440 LTCHs, would affect discharges occurring on or after October 1, 2013.Continue reading...
Transparent pricing becomes marketing tool for Miami hospitalsby Daniel Chang
Once a closely-held competitive secret, hospital prices are beginning to shake loose from the grips of healthcare executives in the wake of last week's unprecedented move by the federal government to publicly share what hospitals bill Medicare for the most common diagnoses and treatments.
The data dump revealed that hospitals across the country, and even in the same communities, charge the government wildly different amounts for the same care, and they receive varying reimbursements from Medicare in return.Continue reading...
A State-by-State Snapshot of Poverty Among Seniors: Findings From Analysis of the Supplemental Poverty Measureby Zachary Levinson,Anthony Damico,Juliette Cubanski and Patricia Neuman
During recent deficit reduction discussions, policymakers have debated whether to increase Medicare beneficiaries’ contributions toward their medical care and reduce the cost of living adjustment to Social Security benefits. Having a clear picture of the extent of poverty among seniors, both nationally and at the state level, is important in the context of these debates. Traditionally, the Census Bureau has estimated poverty rates using the “official” poverty measure, which was created in the early 1960s. Some have expressed concern that the official measure is outdated and does not accurately reflect individuals’ incomes or financial resources.Continue reading...
Up to 1 in 5 children suffer from mental disorder: CDC
by Atossa Araxia Abrahamian
Up to 20 percent of children in the United States suffer from a mental disorder, and the number of kids diagnosed with one has been rising for more than a decade, according to a report released on Thursday by the U.S. Center for Disease Control and Prevention.
In the agency's first-ever study of mental disorders among children aged 3 to 17, researchers found childhood mental illnesses affect up to one in five kids and cost $247 billion per year in medical bills, special education and juvenile justice.
CMS releases final ICD10 code set for October 1, 2014
ICD-10-PCS Code Updates
The 2014 ICD-10-PCS (procedure) files are now available and posted on the CMS website
. ICD-10-PCS will be used for coding inpatient procedures when the U.S. transitions to ICD-10 on October 1, 2014. ICD-10-PCS will replace ICD-9-CM, Volume 3. CPT codes will continue to be used for outpatient procedures and services.
The new ICD-10-PCS files include:
CMS Proposed Rule Would Increase Oversight of Accrediting OrganizationsCMS has issued a proposed rule
that would revise the survey, certification and enforcement procedures related to CMS oversight of national accreditation organizations (AOs). These revisions would implement certain provisions under the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). The proposed revisions would also clarify oversight of AOs that apply for, and are granted, recognition and approval of an accreditation program in accordance with the Social Security Act. According to the proposed rule, health care facilities, with the exception of kidney transplant centers, end-stage renal dialysis facilities and providers of medical equipment and supplies, can demonstrate their compliance with Medicare conditions of participation, conditions of certification or conditions of coverage by being accredited by a CMS-approved organization. The proposed rule would implement, among other things, provisions requiring prospective or existing accreditation organizations seeking CMS approval of their programs to submit documentation proving they are a national accreditation organization, defined as an organization that accredits health care facilities under a specific program and whose accredited health care facilities under each program are widely located geographically across the United States. Comments on the proposed rule are due June 4.
In One State, Cancer Patients 2.65 Times Likelier to File for Bankruptcyby Sue Ducat
A new study, being released as a Web First by Health Affairs
, finds that US cancer patients were 2.65 times more likely to file for bankruptcy than people without cancer. Based on data analysis of 197,840 cancer patients age 18 or older in the western district of Washington State between 1995 and 2009, the study found that 4,408 (2.2 percent) filed for bankruptcy protection after being diagnosed with cancer. Controlling for a variety of factors, the researchers studied another set of 197,840 people from that same region that did not have cancer and found only 2,291 (1.1 percent) among them had filed for bankruptcy.
The study also found that younger people with cancer experienced the highest bankruptcy rates across all cancer types and up to ten times the rate of bankruptcy filings than older age groups.Continue reading...
Office Visits Declined in 2012 Again, but Not as Sharplyby Robert Lowes
Providing further evidence of a cooled-down healthcare sector, the number of physician office visits decreased by 0.9% from 2011 to 2012, according to a new study
released May 9, 2013 by the research firm IMS Health.
However, the decline last year was not nearly as sharp as it was in 2011 and 2010, suggesting office visits may be on the verge of a rebound.
HHS issues rules cutting Medicaid DSHby Rich Daly
The Obama administration issued the rules Monday to carry out a major hospital Medicaid cut, even as it is trying to delay the reduction scheduled to begin in five months.
The Patient Protection and Affordable Care Act required $18.1 billion in reductions to Medicaid disproportionate-share hospital payments from fiscal 2014 through fiscal 2020. Those payments offer extra financial support to hospitals that serve larger-than-average shares of low-income patients and uncompensated-care cases.Continue reading...
Total spending on U.S. medicines fell 3.5 percent on a real per capita basis in 2012 and the use of healthcare services overall declined for the second consecutive year, according to a new study released today by the IMS Institute for Healthcare Informatics.
The report, Declining Medicine Use and Costs: For Better or Worse?, finds that total dollars spent on medications in the U.S. reached $325.8 billion last year, or real per capita spending of $898, down $33 from 2011. Underlying drivers for the overall decline in healthcare service use included fewer patient visits to office-based physicians, fewer non-emergency admissions to hospitals and outpatient facilities, and a less severe flu season in the early part of 2012. In addition, a number of patent expirations in 2012 contributed $28.9 billion to the reduction in medicine spending. This was their largest-ever impact as millions of patients accessed lower-cost generic versions of additional medicines.
Spending on Rx drugs falls for the first timeby Richard Meyer
Nominal, or unadjusted, spending on pharmaceuticals reached $325.8 billion in 2012, a 0.1% decrease from $329.2 billion in 2011 – the first time the growth rate has fallen, said IMS Institute Director of Research Development Michael Kleinrock. Real per capita spend fell 3.5%, or $33 per patient, from $931 in 2011 to $898 in 2012. .Sales to 19 to 25 year olds fell in 2012 – but that was after a spike in 2011 due to a provision in the ACA that allowed them to stay longer on their parents’ insurance. That said, the group only accounted for 3% of total U.S. prescription sales according to the Pink Sheet.Continue reading...