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AHA recommends changes to Medicare ACO programs   04/17/2014
Hospitals are committed to the concept of “accountable care” but continue to have significant concerns about the design of the current Pioneer ACO Model and the Medicare Shared Savings Program, AHA told the Centers for Medicare & Medicaid Services in comments submitted today. “The Pioneer ACO and MSSP programs place too much risk and burden on providers with too little opportunity for reward in the form of shared savings,” wrote Linda Fishman, AHA senior vice president for public policy analysis and development. To increase participation in the programs, AHA recommends that CMS improve the timeliness and accuracy of performance data; extend the Track 1 agreement period; set a standard minimum savings rate of no more than 2%, regardless of the number of attributed beneficiaries; create more achievable financial thresholds in the early years; implement technical adjustments to the benchmark to account for policy changes outside the control of the provider; allow beneficiaries to “opt in” to the programs; allow ACOs to vary beneficiary cost sharing; and simplify and align the quality measures and set the required thresholds prior to the performance year.
CMS posts first IPF quality data to Hospital Compare website   04/17/2014
  The Centers for Medicare & Medicaid Services today posted to the Hospital Compare website the first quality data from 1,753 inpatient psychiatric facilities participating in Medicare’s IPF quality reporting program. The four reported measures include data on the use of physical restraint and seclusion and the creation and transmission of post-discharge continuing care plans for patients discharged between Oct. 1, 2012 and March 31, 2013. CMS last year delayed reporting requirements for two measures related to antipsychotic medications due to technical problems with the data submission portal. IPFs and distinct-part psychiatric units in acute care hospitals reimbursed under the IPF prospective payment system must participate in the program to receive a full payment update.    
HRET names first participants in fellowship to prevent CAUTI   04/17/2014
  The AHA’s Health Research & Educational Trust affiliate today announced the first participants in “Project Protect," a 10-month fellowship focused on preventing catheter-associated urinary tract infections. The 34 infection preventionists, nursing leaders, physicians and patient safety professionals will attend in-person and virtual educational sessions, participate in peer-learning calls and complete a capstone project under the guidance of faculty mentors. Partners in the fellowship, an extension of the national “On the CUSP: Stop CAUTI” project, include the Association for Professionals in Infection Control and Epidemiology, Society of Hospital Medicine, Society for Healthcare Epidemiology of America and Emergency Nurses Association.     
OIG recommends site-neutral policy for certain OPPS, ASC payments   04/17/2014
  The Centers for Medicare & Medicaid Services should reduce Medicare payment rates under the hospital outpatient prospective payment system for low- and no-risk patients receiving procedures that could be performed in ambulatory surgical centers, and should seek authority from Congress to exempt the savings from budget neutrality requirements, the Department of Health and Human Services’ Office of Inspector General said today in a report requested by Congress. The report estimates that this type of site-neutral payment for hospital outpatient departments and ASCs could save Medicare up to $15 billion and beneficiaries $2-$4 billion over six years. CMS did not concur with the recommendations, in part because the OIG did not suggest specific clinical criteria to distinguish patients that can be adequately treated in an ASC relative to a hospital outpatient department.    
Study: Rates for certain diabetes-related complications fall sharply   04/17/2014
  The heart attack rate for patients with diabetes fell 68% between 1990 and 2010, while deaths from hyperglycemic crisis fell 64%, according to a study in today’s New England Journal of Medicine. In addition, diabetes-related stroke cases fell 53%, amputations 51%, and end-stage renal disease cases 28%, the study found. “The findings probably reflect a combination of advances in acute clinical care, improvements in the performance of the health care system, and health promotion efforts directed at patients with diabetes,” the authors said. The annual numbers of amputations, ESRD cases and strokes continue to increase because the number of adults with diabetes has more than tripled over the period, the report notes.     
Hospitals participate in National Healthcare Decisions Day   04/16/2014
Hospitals and others participated today in the seventh annual National Healthcare Decisions Day. The AHA is a partner in the national initiative, which encourages Americans to talk about their future health care decisions and complete an advance directive. For more on the initiative, visit www.nhdd.org. Additional information and resources on advance directives are available at www.aha.org/putitinwriting.
Poll: Uninsured rate for adults down more in certain states   04/16/2014
The uninsured rate for adults has declined more this year in states that expanded Medicaid under the Affordable Care Act and set up state or partnership exchanges than it has in other states, according to the Gallup-Healthways Well-Being Index survey. The rate fell by an average 2.5 percentage points January through March in the 21 states that opted to expand Medicaid and set up state or partnership exchanges, compared with an average 0.8 point drop in other states. The finding is based on respondents’ self-reported insurance status. Only four states have expanded Medicaid without administering a state or federal partnership exchange. Several states continue to debate expanding Medicaid eligibility. According to updated estimates released this week by the Congressional Budget Office and Joint Committee on Taxation, the ACA will increase health insurance coverage by 4 percentage points or 12 million people in 2014. By 2024, they expect the ACA to reduce the number of uninsured non-elderly U.S. residents by 26 million, one million more than their previous estimate. The report also lowers the projected net cost of the ACA’s health coverage provisions by $5 billion for 2014 and by $104 billion for 2015-2024.
Task force issues price transparency recommendations, consumer guide   04/16/2014
A Healthcare Financial Management Association task force, whose members include the AHA, today issued price transparency recommendations for health plans, health care providers and others, and a guide to help consumers estimate the cost of care. Health plans should serve as the principal source of price information for insured patients, and providers for uninsured patients and those seeking out-of-network care, the task force said. Among other information, price transparency tools for insured patients should include the estimated total price and out-of-pocket costs for the service being sought and whether particular providers are in the health plan’s network, while tools for uninsured and out-of-network patients should clearly communicate pre-service price estimates and which services are/are not included in the estimate, the panel said. AHA President and CEO Rich Umbdenstock said the association “fully supports” the recommendations. “Providing understandable and useful information about the price of hospital care is one of the ways America’s hospitals are working to improve the health of their communities,” he said.
CMS revises application request for ESRD payment, care delivery model   04/15/2014
The Centers for Medicare & Medicaid Services today released a revised Request for Applications for the Comprehensive End-Stage Renal Disease Care Model. Announced last February, the Center for Medicare and Medicaid Innovation project will test whether organizations comprised of dialysis facilities (including hospital-based facilities), nephrologists and other Medicare providers and suppliers can reduce costs and improve care coordination and quality for Medicare fee-for-service beneficiaries with end-stage renal disease. Among other changes, the revised RFA removes a requirement that participating nephrologists and nephrology practices be independent entities, and offers two payment tracks based on the size of the participating dialysis facilities. Organizations that include at least one dialysis facility owned by a large dialysis organization must submit a letter of intent and application by June 23 and others by Sept. 15. For more information, see the CMS factsheet.
Members encouraged to submit videos to AHA's 'My Hospital' campaign   04/15/2014
AHA recently launched a digital video campaign highlighting the importance of hospitals in their communities, and encourages members to submit videos to the campaign using Instagram and other mobile video applications that are sharable through Twitter. AHA will promote the videos during its annual meeting May 4-7 in Washington, D.C., and share them on Facebook and through social media, tagging respective elected representatives for each hospital that participates. For more information, including participation instructions and a sample script, visit www.aha.org/myhospital.