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AHA releases patient blood management toolkit   04/18/2014
AHA and its Physician Leadership Forum have released a toolkit developed with AABB and others to help hospitals and health systems implement a patient blood management program. The resources include a tool to help senior management, quality leaders and others assess their hospital’s readiness to adopt a formal PBM program, a May 1 webinar and other resources for clinicians, and a patient handout that answers common questions about transfusion and PBM. In a white paper last year on appropriate use of medical resources, AHA identified appropriate blood management in inpatient services as one of the “top five” hospital-based procedures or interventions that should be reviewed and discussed by a patient and physician before proceeding. The PLF plans to release a toolkit on each of the five areas over the next year. For more on the PBM toolkit, see yesterday’s AHA Quality Advisory.    
CMS call Tuesday on e-template for physician HH documentation   04/18/2014
The Centers for Medicare & Medicaid Services on Tuesday will host the first in a series of conference calls to receive feedback on a proposed electronic template for physicians documenting a face-to-face encounter with patients transitioning from hospitals and other settings to home care. Medicare requires a physician to meet face-to-face with patients transitioning to home care to certify that home care is medically necessary. The template is not intended as a data entry form but would allow electronic health record vendors to create prompts for physicians documenting the encounter.    
Hospitals given extra week to complete AHA RACTrac survey   04/18/2014
The AHA has extended to April 25 the deadline for hospitals to submit data to its quarterly RACTrac survey. Participants are asked to answer a new survey question measuring the number of claims withdrawn from the appeals process in order to rebill for Part B payment. The free web-based survey helps AHA gauge the impact of Medicare's Recovery Audit Contractor program on hospitals and advocate for needed changes. To register for the survey or for technical assistance, contact RACTrac support at (888) 722-8712 or ractracsupport@providercs.com. For more on the survey, including the latest results, visit www.aha.org/ractrac.    
Report: Lack of interoperability impeding health information exchange   04/18/2014
A lack of interoperability among the data resources for electronic health records “is a major impediment to the effective exchange of health information,” according to a new report by JASON, an independent group of scientists that advises the federal government on technology. “Although current efforts to define standards for EHRs and to certify HIT systems are useful, they lack a unifying software architecture to support broad interoperability,” the report states. The authors conclude that current meaningful use requirements amount “to little more than replacing fax machines with electronic delivery of page-formatted medical records.” Among other recommendations, the report calls for the Centers for Medicare & Medicaid Services to “embrace Stage 3 meaningful use” requirements for the Medicare & Medicaid EHR Incentive Programs “as an opportunity to break free from the status quo and embark upon the creation of a truly interoperable health data infrastructure.” It also calls for the Office of the National Coordinator to consult with stakeholders to define within 12 months “an overarching software architecture for the health data infrastructure. The architecture should provide a logical organization of functions that allow interoperability, protect patient privacy, and facilitate access to clinical care and biomedical research.” The report, prepared for the Agency for Healthcare Research and Quality, provides an example of what such an architecture might look like, including a migration pathway to transition from the current system of EHRs to a more interoperable system in the future.
White House: 8 million enrolled through health insurance marketplace   04/18/2014
About 8 million people signed up for private health insurance through a state or federally-facilitated marketplace during open enrollment, the White House announced yesterday. About 35% of those enrolling through a federally-facilitated marketplace were under age 35, of which 28% were adults, about the same proportion as Massachusetts experienced in its first year of health reform, the White House said. The Department of Health and Human Services gave consumers who were “in line” but unable to complete enrollment by the March 31 deadline for open enrollment until April 15 to complete the process. Officials have not said how many enrollees were previously uninsured or have paid their initial premium. According to findings from a Gallup Daily tracking survey released this week, about 4% of U.S. adults are newly insured this year.    
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.