Congress, HHS urged to extend meaningful use timelines   07/24/2013
The Department of Health and Human Services should extend and make more flexible the meaningful use timelines for the Medicare Electronic Health Record Incentive Program to ensure a safe, orderly transition to the next phase of the program that leaves no health care providers behind, AHA told the Senate Finance Committee and HHS today. “In particular, small and rural hospitals lag behind their larger and urban counterparts,” AHA said in a statement submitted to the committee for a hearing on the issue. “…Our recommendations would allow Stage 2 to start in 2014, but the transition would be more safe and orderly.” Specifically, AHA recommends that HHS allow providers at Stage 1 to meet requirements using either the 2011 or 2014 certified Edition EHR; extend each stage of meaningful use to no less than three years for all providers; establish a 90-day reporting period for the first year of each new stage of meaningful use for all providers; offer greater flexibility to providers in meeting Stage 2; and redirect the electronic clinical quality reporting requirements to focus on a small set of well-tested measures. The American Medical Association joined AHA in submitting similar recommendations to HHS, noting that “time is of the essence in addressing these concerns.” Marty Fattig, CEO of Nemaha County Hospital in Auburn, NE, testified at the hearing. “Policymakers will need to make changes to the meaningful use program to narrow the digital divide and to ensure small and rural hospitals are not left behind as they transition to Stage 2 of meaningful use, and as the positive incentives quickly turn to significant payment penalties,” Fattig said.
House members urge CMS to revise stroke-related quality measures   07/24/2013
Twenty-three members of the House Congressional Heart and Stroke Coalition yesterday urged the Centers for Medicare & Medicaid Services to work with stakeholders to revise two stroke-related quality outcome measures included in its proposed rule for the inpatient prospective payment system in fiscal year 2014 to adjust for stroke severity before issuing a final rule. “We understand that the National Quality Forum voted to reject the stroke hospital readmission measure last October and that CMS voluntarily withdrew the stroke mortality measure from NQF consideration at the same time ‘in order to reevaluate their approach to risk adjustment,’” the bipartisan group of U.S. representatives said in a letter to CMS Administrator Marilyn Tavenner. “Although we recognize that no measure is perfect, we believe it would be a mistake for CMS to move forward with the adoption of these measures without first addressing the very significant concerns that have been raised about them by the stroke community.” AHA supports the coalition’s letter and expressed similar concerns with the two measures in comments submitted to CMS.
Outpatient supervision bill introduced in House   07/24/2013
Reps. Kristi Noem (R-SD) and Collin Peterson (D-MN) yesterday introduced a House companion to the Protecting Access to Rural Therapy Services Act (S. 1143/H.R. 2801), AHA-supported legislation that would allow general supervision by a physician or non-physician practitioner for many outpatient therapy services. The bill would require the Centers for Medicare & Medicaid Services to allow a default setting of general supervision, rather than direct supervision, for outpatient therapy services and create an advisory panel to establish an exceptions process for risky and complex outpatient services. The legislation also would create a special rule for critical access hospitals that recognizes their unique size and Medicare conditions of participation; and would hold hospitals and CAHs harmless from civil or criminal action for failing to meet the “direct supervision” requirements applied to services furnished since 2001.
IOM issues final report on regional variation in health spending   07/24/2013
Congress should not adopt a geographically based value index for Medicare payments, because the majority of health care decisions are made at the provider or health care organization level, not by geographic units, according to a congressionally mandated study released today by the Institute of Medicine. The IOM committee was asked to investigate geographic variation in health care spending and quality and to analyze Medicare payment polices that might encourage high-value care, including adoption of a geographically-based value index that would modify provider payments based on composite cost and quality measures of geographic-area performance. The study confirmed that regional differences in Medicare and commercial spending and use of services are large, and found that much of the variation remained unexplained even after analysis that controlled for a variety of health, demographic and market factors. Adjusting payments geographically based on any aggregate or composite measure of spending or quality would unfairly reward low-value providers in high-value regions and punish high-value providers in low-value regions, the committee said. To promote high-value services from all providers, the committee said CMS should continue to test payment reforms that offer incentives to providers to share clinical data, coordinate patient care, and assume some financial risk for the care of their patients.
FL, TN hospital associations recognized for quality leadership   07/24/2013
The Florida Hospital Association and Tennessee Hospital Association on Thursday will receive the 2013 Dick Davidson Quality Milestone Award for Allied Association Leadership at the Health Forum-AHA Leadership Summit in San Diego. "Hospital associations play a critical role in leading quality and patient safety efforts in their own states,” said AHA President and CEO Rich Umbdenstock. “The efforts of the FHA and THA also serve as a model of successful quality leadership for hospital associations across the country.” The annual award is named for AHA President Emeritus Dick Davidson, who strongly promoted the role of hospital associations in leading quality improvement during his tenure as AHA president and as president of the Maryland Hospital Association. For more on the 2013 recipients’ quality and safety efforts, see the AHA news release.