Leapfrog posts confidential updated safety grades for hospitals   11/21/2012
The Leapfrog Group today posted for hospitals' review letter grades associated with the updated hospital safety scores it plans to release to the public later this month. Critical access hospitals, Maryland hospitals, specialty hospitals, mental health hospitals, pediatric hospitals and federal hospitals are excluded from the grades and scores, which were posted to the website last week. All other hospitals are urged to review their updated scores and grades at www.leapfroggroup.org/data-validation/hospital_data_review using the username and passwords they received in October. For assistance, contact the Safety Score Help Desk at https://leapfrogscore.zendesk.com/.
Federal court vacates 2004 Medicare DSH policy change   11/21/2012
The U.S. District Court for the District of Columbia last week held that a 2004 Department of Health and Human Services rule changing Medicare's formula for calculating disproportionate share hospital payments for hospitals that treat Medicare Advantage patients was procedurally flawed and must be vacated. "The Court concludes that the Secretary's interpretation of the fractions in the DSH calculation, announced in 2004 and not added to the Code of Federal Regulations until the summer of 2007, was not a 'logical outgrowth' of the 2003 [notice of proposed rulemaking]," the opinion by U.S. District Judge Rosemary Collyer states. Finding that the reasoning for the change was "brief and unconvincing," the court also held that the rulemaking was arbitrary and capricious. The case (Allina v. Sebelius) was remanded to the HHS secretary "for further action consistent with this opinion."
OIG: Medicare should improve appeals at ALJ level   11/21/2012
Administrative law judges reversed decisions by qualified independent contractors and decided fully in favor of appellants in 56% of appeals of Medicare decisions related to claims for health care services and items in fiscal year 2010, according to a report released last week by the Department of Health and Human Services' Office of Inspector General. ALJs differed from QICs in their interpretation of Medicare policies, their degree of specialization and their use of clinical experts, OIG found. Among other actions, the report recommends that the Office of Medicare Hearings and Appeals and Centers for Medicare & Medicaid Services provide coordinated training on Medicare policies to ALJs and QICs who decide appeals; identify and clarify Medicare policies that are unclear and interpreted differently; and revise regulations to provide more guidance to ALJs regarding the acceptance of new evidence. In addition, OIG recommends that OMHA implement a quality assurance process to review ALJ decisions, and determine whether specialization among ALJs would improve consistency and efficiency. It also recommends that CMS increase its participation in ALJ appeals. When CMS participated, ALJs were less likely to decide fully in favor of appellants, the report notes.
Online access to medical records may increase use of services   11/21/2012
Patients who have online access to their medical records and clinicians use more clinical services than patients who do not, according to a study at Kaiser Permanente Colorado reported in today's Journal of the American Medical Association. "In the year following activation, members with such access had increased rates of office visits, telephone encounters, and acute care services compared with a matched cohort of members without online access," researchers at the integrated health care delivery system found. "…If these findings are evident in other systems, health care delivery planners and administrators will need to consider how to allocate resources to deal with increased use of clinical services."
Equity of Care newsletter honored   11/21/2012
The Equity of Care monthly newsletter recently received an honorable mention in the Association of Marketing and Communication Professionals' 2012 MarCom Awards competition, which recognizes outstanding creative achievement by marketing and communication professionals. Launched last year by the AHA, Association of American Medical Colleges, American College of Healthcare Executives, Catholic Health Association of the United States, and National Association of Public Hospitals and Health Systems, Equity of Care is a national call to action to eliminate health care disparities by increasing diversity in health care governance and management; cultural competency training for clinicians and support staff; and collection and use of race, ethnicity and language preference data. The newsletter provides stories, reports and case studies to help promote equitable care and diversity.