CMS issues additional guidance on two-midnight policy   11/04/2013
The Centers for Medicare & Medicaid Services late Friday issued additional guidance related to its two-midnight inpatient hospital medical review and admission criteria. Specifically, the CMS website now indicates that in general, CMS will not conduct post-payment patient status reviews for claims with dates of admission Oct. 1, 2013 through March 31, 2014, three months longer than previously announced. In addition, CMS posted two documents at the website setting forth more details on the “probe and educate” audits that will be conducted by Medicare Administrative Contractors, announced in the agency’s Sept. 26 guidance. According to AHA staff, the new guidance attempts to provide the hospital field with much needed clarification on the two-midnight policy, but lacks clarity and certain parts appear to be inconsistent with guidance previously issued by the agency. AHA continues to review the updates and will provide more information to members tomorrow in a Special Bulletin.
NH rural hospital initiative receives AHA Living the Vision Award   11/04/2013
AHA today presented the Carolyn Boone Lewis Living the Vision award to Cheshire Medical Center/Dartmouth-Hitchcock Keene in Keene, NH, for its work to improve the health of its community through actions that go beyond traditional hospital care. The 169-bed rural hospital and primary care/multi-specialty clinic is the driving force behind “Healthy Monadnock 2020,” a community-wide initiative to become the nation's healthiest community by 2020 through environmental and policy changes that make the healthy choice the easy choice for individuals, schools, workplaces and towns. “By reaching out to the community and partnering with organizations that touch every part of community life, Cheshire Medical Center/Dartmouth Hitchcock Keene has made this vision possible,” said AHA President and CEO Rich Umbdenstock. “I am pleased and honored to recognize them for their on-going efforts to meet the health needs of the communities they serve.” The award is named in memory of the first hospital trustee to serve as AHA chair.
Survey gauges early interest in new health insurance marketplaces   11/04/2013
About 17% of adults who are uninsured or have individual health coverage report visiting the new health insurance marketplaces to shop for a health plan via the Internet, mail, phone or in person, according to a survey released today by the Commonwealth Fund. About one in five of them said they enrolled in a health plan. Among other reasons, those who did not enroll said they were not sure they could afford a plan (48%), were still trying to decide which plan they want (46%) or experienced technical problems with the marketplace website (37%). About six in 10 adults who had not yet gone to a marketplace or enrolled said they were somewhat or very likely to enroll in a plan or find out if they are eligible for financial help before the enrollment period ends on March 31. Sixty percent of survey respondents were aware of their state’s marketplace and 53% were aware that financial help may be available to help pay for their coverage. Nearly three-quarters of respondents favored making Medicaid available to more residents in their state.
Study looks at CAHs and cost shifting   11/04/2013
A study reported today in JAMA Internal Medicine concludes that hospital systems that include critical access hospitals and non-CAH hospitals could use accounting practices to shift costs to CAHs and maximize cost-based payments, increasing costs by an estimated $150 million a year. However, the study does not examine whether the shifting of costs occurs as a result of cost-based reimbursement or as a result of care being appropriately shifted from a prospective payment system acute hospital to the CAH. “The study attempts to undercut the vital role CAHs play in providing essential medical care to the 19.3% of the U.S. population that resides in rural areas,” said Priya Bathija, AHA senior associate director of policy.
HANYS reports on hospital 'report cards'   11/04/2013
Organizations that grade or rate the quality of hospital care use widely varying approaches that can confuse consumers by producing dramatically different results for the same hospital, according to a report released today by the Healthcare Association of New York State. "What hospitals and patients need and deserve is a standardized, accurate, clinically-based method of measuring and comparing hospital quality," said HANYS President Dennis Whalen. "This report provides a critically needed analysis that we hope will help hospitals to evaluate the usefulness of these report cards and stimulate a broader discussion.” The report compares 10 national and state-specific hospital quality reports, including The Joint Commission Quality Check; Centers for Medicare & Medicaid Services’ Hospital Compare; Niagara Health Quality Coalition; Leapfrog Group Hospital Safety Score; Truven Health Analytics 100 Top Hospitals; Healthgrades America’s Best Hospitals; Consumer Reports Hospital Safety Ratings; and U.S. News and World Report.