CMS Releases Proposed Rule for 2014 Payment Policies

cmsThe Centers for Medicare & Medicaid Services distributed a press release on Friday revealing its proposed rule for the agency’s 2014 payment schedule.  While the rule does include small increases in payments for many acute and long-term care hospitals, it is being widely criticized for reimbursement changes that would heavily penalize organizations including public hospitals that typically treat higher numbers of uninsured patients.  Hospitals have until June 25 to provide commentary on the proposed rule.

The proposed rule includes a 0.8 percent increase in payments to acute care hospitals, projected to total about $27 million, as well as a 1.1 percent increase for long-term care facilities that could amount to $62 million.  On the contrary, proposed changes will dictate that about three-quarters of the disproportionate share hospital payments made to facilities serving higher uninsured populations will fluctuate for the year.

The proposal also includes a freeze in Medicare payments to physicians, as required by the American Taxpayer Relief Act, which will serve as the first step toward cutting $11 billion in acute-care payments over the next four years. In addition, the rule imposes penalties for failure to reduce hospital-acquired conditions, as mandated by the Patient Protection and Affordable Care Act, as well as changes to the 30-day readmissions program, which includes, for the first time, knee and hip replacements and chronic obstructive pulmonary disorder. Hospitals that do not participate in the Hospital Inpatient Quality Reporting (IQR)Program will suffer penalties according to the rule as well.

To read the full text of the CMS proposed rule, click here.

5 Stories You Need But May Have Missed This Week

mednews-roundup-logo-300x122We know you’re busy, but we don’t want you to miss important healthcare quality and patient safety news. Below is a roundup of stories you may have missed but need to take a look at before calling it a week. (Sign up on the right if you’d like these news alerts delivered to you.)

  1. Missed, wrong diagnoses most dangerous errors, study says
    Analysis of over 25 years worth of malpractice data places misdiagnoses as a more common culprit in causing patient harm than the occurrence of more publicized “never events.”  This article discusses the financial impact of these errors as well as the need for liability reform that would include specific policies related to diagnostic error.
  2. Safer Hospital Rooms
    How thoroughly do hospital rooms need to be cleaned between patients? Access a fascinating study and discover how a three-step disinfection technique, implemented at Louis Stokes Cleveland Veterans Affairs Medical Center, virtually eradicated Clostridium difficile.
  3. Hospital Compare Adds Interactive Data
    Learn how the Centers for Medicare & Medicaid Services has improved its Hospital Compare website tool by incorporating a new interface called “Socrata” which allows regional comparisons of hospital data.
  4. Mandatory glove wearing may reduce risk of hospital-acquired infections
    A study performed by the University of Iowa College of Public Health has shown significant  reductions in the rate of  HAIs, including central line-associated bloodstream infections, as a result of mandatory gloving in hospital pediatric units.
  5. Hospital ‘ACE’ Teams Curb Adverse Events, LOS, Costs
    Find out what two recent studies, published in the JAMA Internal Medicine, revealed about how “Acute Care of the Elderly” teams are helping hospitals better meet the unique needs of geriatric patients and cutting costs while doing it.

 

 

[STUDY] Patient Engagement Key to Learning from Clinical Data

Authors of a new discussion paper released by the Institute of Medicine believe the patient/provider relationship is key to successful development of a new system of learning from clinical data.  According to the research, patients today are more knowledgeable and better equipped than ever to contribute to this kind of learning process, and clinicians need to leverage this engagement.

In the paper, researchers state that to “achieve the aim of better health by learning from routinely collected health data, we believe patients and clinicians alike should be full participants in viewing every health care encounter as an opportunity to improve outcomes, not only for the individual patient, but also for others like them.”

The paper, Making the Case for Continuous Learning from Routinely Collected Data, details examples of how regularly collected clinical data is being used to improve patient services and communication, avoid harm and speed research.

To read the discussion paper, click here.

4 Stories You Need But May Have Missed This Week

mednews-roundup-logo-300x122We know you’re busy, but we don’t want you to miss important healthcare quality and patient safety news. Below is a roundup of stories you may have missed but need to take a look at before calling it a week. (Sign up on the right if you’d like these news alerts delivered to you.)

  1. IT key for Boston bombing patients
    Read perspectives from physicians and administrators from four major Boston hospitals detailing the supporting roles their IT departments played while clinicians worked feverishly to provide care for those injured in this week’s marathon-day bombing.  Learn ways that the Center for Connected Health suggests mobile communication could come into play as these victims continue to recover – – from remote patient monitoring and video conferencing  to motivational messaging and care reminders.
  2. Engaged Patients Cost Less
    Low health literacy is epidemic nationwide. Improving communication with patients would not only yield better outcomes but would generate incredible savings across the healthcare industry.  Read why investing in and shaping better partnerships with patients makes perfect sense.
  3. Health Plan’s Secret Sauce is Social Media
    Discover how Magellan Health System used a Facebook-like social media site to reduce readmissions and engage patients discharged from the hospital following treatment for substance abuse.  This fascinating pilot study allowed clinicians to monitor patient behaviors via regularly posted emoticons indicating how they were feeling and fostered support systems through the facilitation of anonymous patient-to-patient online connections.  The program’s success brings hope for bridging the care gap for other chronic conditions.
  4. CMS Memo Urges Use of Common Formats
    The Centers for Medicare and Medicaid Services released a memo on March 15, 2013 explaining how use of the Agency for Healthcare Research and Quality’s Common Formats can help hospitals improve adverse event reporting and meet the CMS Quality Assessment and Performance Improvement (QAPI) requirements.

 

 

CMS Memo Urges Use of Common Formats

common formats logoThe Centers for Medicare and Medicaid Services released a memo on March 15, 2013 explaining how use of the Agency for Healthcare Research and Quality’s Common Formats can help hospitals improve  adverse event reporting and meet the CMS Quality Assessment and Performance Improvement (QAPI) requirements.

While use of AHRQ’s Common Formats is not mandatory for hospitals, CMS stated in its memo, “we suggest, however, that a hospital that uses the Common Formats and is adept at the analysis that this structured system permits, will be in a better position to meet the CMS QAPI requirements.”

An attachment to the memo defines the types of incidents, near misses and unsafe conditions that have potential for causing harm to patients but too frequently go unreported.  In addition, the supplemental document provides information regarding the structure generic and event-specific formats that can be used to report these potentially harmful events.

To read the March 15 CMS memo and the supplemental attachment, click here.

 

5 Stories You Need But May Have Missed This Week

mednews-roundup-logo-300x122We know you’re busy, but we don’t want you to miss important healthcare quality and patient safety news. Below is a roundup of stories you may have missed but need to take a look at before calling it a week. (Sign up on the right if you’d like these news alerts delivered to you.)

  1. ONC proposes EHR vendor fee
    Read the HIMSS EHR Association’s position statement on the Office of the National Coordinator’s proposed health IT user fee for vendors who certify their products through the ONC’s Health IT Certification Program.
  2. 50 Experts Leading the Field of Patient Safety
    Scroll through this patient safety “A-list,” published by Becker’s Hospital Review, of 50 advocates, professors, researchers, administrators and healthcare providers who are publishing articles, speaking out and leading successful initiatives to reduce harm and ensure safety within the healthcare industry.
  3. HIT Errors ‘Tip of Iceberg,’ Says ECRI
    As health systems are transitioning from paper to electronic records, mistakes are happening — serious mistakes.  Find out what researchers learned from data collected during a nine-week voluntary program implemented last spring by ECRI Institute.
  4. Video Cameras in the OR May be Inevitable
    Learn why a growing group of proponents for using video cameras in operating rooms want surgeons to become more proactive about recording their procedures and how doing so will impact quality improvement in ways that go well beyond preventing tragic mistakes.
  5. TJC Issues Sentinel Event Alert on Medical Device Alarms
    While hospitals depend on an array of alarm-equipped devices to collect information necessary to providing appropriate care to patients, these devices present a host of challenges for clinicians. Access the Sentinel Event Alert issued by The Joint Commission this week involving this serious patient safety risk and read the suggestions the agency is making to improve alarm safety.

 

 

TJC Issues Sentinel Event Alert on Medical Device Alarm Safety

TJCWhile hospitals depend on an array of alarm-equipped devices to collect information necessary to providing appropriate care to patients, these devices present a host of challenges for clinicians. According to The Joint Commission, nearly 100 adverse events involving alarmed medical devices occurred between January 2009 and June 2012.  Eighty of these events resulted in a patient death, and in 13 of the cases, patients experienced permanent loss of function.

TJC has issued a Sentinel Event Alert  aimed at warning hospitals of the many dangers presented by medical device alarm systems and identifying opportunities to improve alarm safety.

Out of the tens of thousands of alarms that echo through hospitals every day, between 85 and 99 percent of the signals do not require any sort of staff intervention.  For this reason, clinicians often turn the volume down on the alarms or eventually develop “alarm fatigue” and become desensitized them.  Ignoring these alerts or assuming them to be false or nonemergency alarms, however, means that clinicians are not receiving vital warnings of impending trouble with patients who may need immediate attention.

TJC is also considering establishing a National Patient Safety Goal aimed addressing this serious patient safety issue.  In the meantime, the agency has worked with organizations including the Association for the Advancement of Medical Instrumentation (AAMI) and  ECRI Institute to develop recommendations that could help reduce patient harm in the short term. These recommendations include:

  • Establish processes for safe alarm management and response in high-risk areas
  • Identify and set appropriate limits for default alarm settings for equipment used in high-risk settings
  • Establish guidelines for identifying situations when alarm signals are not clinically necessary
  • Establish guidelines for tailoring alarm settings and limits for individual patients
  • Regularly inspect, check and maintain alarm-equipped devices depending on provisions of manufacturers, risk levels and experience

Additional strategies being suggested by TJC include providing more thorough and consistent training regarding the use of alarmed devices for entire clinical care teams as well as assessing the acoustics in patient settings to determine how audible a sounding alarm would be for clinicians.

To learn more about TJC’s recommendations for addressing medical device alarm safety, click here.