CMS: Method II physicians eligible for Medicare EHR incentives   01/11/2013
Certain physicians who provide services in the outpatient departments of critical access hospitals are eligible to participate in the Medicare Electronic Health Record Incentive Program beginning this year, according to the Centers for Medicare & Medicaid Services. However, due to CMS system changes that will be implemented over the coming year, these physicians will not be able to submit attestations until January 2014. They will not be able to receive incentives for 2012. The announcement came in response to a letter from AHA Executive Vice President Rick Pollack requesting timely action to address this acknowledged issue. The affected physicians are those for whom a CAH bills Medicare for their outpatient department services using optional Method II. Under this method, the CAH bills Medicare on behalf of the physician for services covered under the Medicare Physician Fee Schedule. Due to system constraints, CMS did not include these Method II claims when it identified which physicians were eligible for its incentive programs. As a result, Method II physicians were inappropriately excluded from the EHR incentive program because they were designated as "hospital-based" when they are not. For more, see the CMS factsheet.
MedPAC finalizes 2014 recommendations for post-acute care   01/11/2013
At a two-day meeting concluding today, the Medicare Payment Advisory Commission recommended no marketbasket update for inpatient rehabilitation facilities, long-term care hospitals and home health providers in 2014. The commission also restated its prior recommendation for a two-year rebasing of the HH payment system starting in 2013, rather than the four-year rebasing starting in 2014 mandated by the Patient Protection and Affordable Care Act. During the post-acute sessions, commissioners discussed the ongoing need for a patient-centered approach to determining the type and amount of post-acute care for beneficiaries, repeatedly noting the potential future benefit of bundling hospital and post-acute payments. MedPAC approved 2014 recommendations for skilled nursing facilities last month, which call for no marketbasket update and rebasing the SNF prospective payment system to better align payments with costs, which would result in an estimated 4% payment reduction in the first year. The commission projects 2013 Medicare margins of 11.8% for HH, 11%-14% for SNFs, 8.5% for IRFs and 5.9% for LTCHs.
AHA updates VBP penalty calculator   01/11/2013
The AHA has updated its value-based purchasing calculator to incorporate the final incentive payment adjustment factors for fiscal year 2013. The calculator helps AHA members estimate their net gain or loss from the VBP program.
AHA report highlights bundled payment considerations for hospitals   01/11/2013
A new issue brief from the AHA highlights issues and data for hospitals to explore when considering bundled payment for an episode of care. Topics for analysis include defining the episode of care; analyzing the distribution of costs and sources of cost variation; tracking patient pathways; assessing the performance of post-acute providers and physician practice patterns; identifying potential risks; and setting the bundle price.
CMS names 106 new Medicare ACOs   01/11/2013
Physicians and hospitals have formed 106 new accountable care organizations to participate in the Patient Protection and Affordable Care Act's Medicare Shared Savings Program, the Centers for Medicare & Medicaid Services announced yesterday. Fifteen of the groups will participate in the program's Advance Payment Model, which provides advance payment of expected shared savings to rural and physician-based ACOs that would benefit from additional start-up resources. MSSP participants agree to be held accountable for improving the health and experience of care for Medicare fee-for-service beneficiaries while reducing the rate of growth in health care spending. To date, more than 250 organizations have formed Medicare ACOs, which are expected to serve more than 4 million beneficiaries. About half of the ACOs are physician-led organizations serving fewer than 10,000 beneficiaries, and about 20% include community health centers, rural health centers and critical access hospitals that serve low-income and rural communities, CMS said. Additional hospitals and physicians can apply to the program this summer.
Hospitals encouraged to tune-in to CDC webcast on preventing VTE   01/11/2013
The Centers for Disease Control and Prevention will host a Jan. 15 webcast on preventing venous thromboembolism (VTE), which will focus on the hospital setting. VTE consists of two related conditions caused by blood clots: deep vein thrombosis and pulmonary embolism. Up to half of all VTEs occur during or after a hospital stay. Hospital clinical staff, quality improvement leaders and risk managers are encouraged to tune-in to the webcast from 1-2 p.m. Eastern Time at
Reminder: Deadline for Dick Davidson quality award approaching   01/11/2013
The AHA invites applications through Jan. 25 for the 2013 Dick Davidson Quality Milestone Award for Allied Association Leadership. Named after AHA President Emeritus Dick Davidson, the annual award honors a state, regional or metropolitan hospital association that demonstrates exceptional organizational leadership and innovation in quality improvement and has made significant contributions to measurable quality improvement in its geographic area. For more information and an application, click here.