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Thursday, Jul 28, 2016
  • Contact Information
  • We are located in the BioTech One building of the VA Bio•Technology Research Park.

    SMA Informatics
    800 E. Leigh Street
    Suite 206-14 Building One
    Richmond, VA 23219

    Phone: (804) 344-8111
    FAX: (804) 344-8113

Last Modified: May 10, 2016
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News Item - 07/27/2016
Many Well-Known Hospitals Fail To Score 5 Stars In Medicare’s New Ratings
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.

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News Item - 07/22/2016
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.

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News Item - 07/21/2016
CMS issues data on national distribution of overall hospital star ratings
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.”

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News Item - 07/18/2016
New Health System Scorecard Finds Improvement in Most U.S. Communities Since ACA Took Effect
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.

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News Item - 07/14/2016
Analysis Finds End-of-Life Medicare Spending Declines With Age Among Seniors
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.

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News Item - 07/07/2016
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.

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News Item - 07/07/2016
CMS releases 2017 OPPS/ASC proposed rule
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.

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News Item - 06/30/2016
CMS’ Open Payments Program Posts 2015 Financial Data
Health care industry manufacturers reported $7.52 billion in payments and ownership and investment interests to physicians and teaching hospitals in 2015

Today, the Centers for Medicare & Medicaid Services (CMS) published 2015 Open Payments data, along with newly submitted and updated payment records for the 2013 and 2014 reporting periods, at  The Open Payments program (sometimes called the “Sunshine Act”) requires that transfers of value by manufacturers of drugs, devices, biologicals, and medical supplies that are paid to physicians and teaching hospitals will be published on a public website.

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News Item - 06/29/2016
Modifying Medicare’s Benefit Design Could Reduce Federal Spending But With Cost Tradeoffs for Beneficiaries
Revamping traditional Medicare’s benefit design and restricting “first-dollar” supplemental coverage could reduce federal spending, simplify cost sharing, protect against high medical costs, decrease out-of-pocket spending for many beneficiaries, and provide more help to those with low incomes — but would be unlikely to achieve all of these goals simultaneously, finds a new analysis by the Kaiser Family Foundation.

The analysis, which draws upon policy parameters put forth by the Congressional Budget Office, the Medicare Payment Advisory Commission and other organizations, examines a general approach to reforming Medicare that has been a focus of Congressional hearings and featured in several broader debt reduction and entitlement reform proposals, including the House GOP health plan released last week.

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News Item - 06/27/2016
Total Medicaid and CHIP Enrollment as of March 2016
This monthly report on state Medicaid and Children’s Health Insurance Program (CHIP) data represents state Medicaid and CHIP agencies’ eligibility activity for the calendar month of March 2016. This report measures eligibility and enrollment activity for the entire Medicaid and CHIP programs in all states, reflecting activity for all populations receiving comprehensive Medicaid and CHIP benefits in all states, including states that have not yet chosen to adopt the new low-income adult group established by the Affordable Care Act. This data is submitted to CMS by states using a common set of indicators designed to provide information to support program management and policy-making related to application, eligibility, and enrollment processes.

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Understanding MS-DRG Grouping under ICD-10
Understanding MS-DRG Grouping under ICD-10
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!

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NHA White Paper - 12/08/2015
CMS receives 380+ submissions and commentary about Joint Replacement Program Proposed Regulations.
CMS has issued the final Joint Replacement program regulations, which are complex.

SMA White Paper - 08/31/2015
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.

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SMA White Paper - 08/31/2015
Contents extracted from Health Affairs publication August 2015.
Health spending growth in the United States is projected to average 5.8
percent for 2014-2024.

This paper provides an overview to National Health Expenditures which can be
used as reference data.

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