Tag Archives: hospital readmissions

CMS Call: Medicare Acute Care Quality and Reporting Programs (May 12)

On May 12, 2015, CMS is hosting a call that will provide an overview of all Medicare hospital inpatient quality reporting and value-based purchasing programs. Specifically, the call will cover: the Hospital Inpatient Quality Reporting (IQR) Program; the Hospital Value-Based Purchasing (HVBP) Program; the Hospital Acquired Condition Reduction Program (HACRP); the Hospital Readmission Reduction Program (HRRP); … Continue Reading

OIG Focuses on Hospitalization of Nursing Home Patients

A recent OIG report, "Medicare Nursing Home Resident Hospitalization Rates Merit Additional Monitoring,” examines the extent to which Medicare nursing home residents are hospitalized. The OIG found that in FY 2011, nursing homes transferred one quarter of their Medicare residents to hospitals for inpatient admissions in FY 2011, and Medicare spent $14.3 billion on these hospitalizations. Septicemia … Continue Reading

Medicare Home Health PPS Rates Cut 1.05% Under Final 2014 Rule

Under the final Medicare home health PPS (HH PPS) rule released on November 22, 2013, payments in 2014 will be cut by 1.05% (about $200 million) compared to 2013 levels (and compared to a -1.5% cut forecast in the proposed rule). This reduction reflects a 2.3% home health payment update, which is more than offset by … Continue Reading

Ways and Means Committee Releases Draft Medicare Post-Acute Care Reform Legislation

The House Ways and Means Committee is inviting comments on draft legislation to reform Medicare post-acute care (PAC) policy, based on reforms included in President Obama’s fiscal year 2014 budget. The legislation would: 1. Reduce market basket updates for home health agencies, skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs) and long-term care hospitals; 2. … Continue Reading

Medicare Home Health PPS Rates to Drop under Proposed CY 2014 Rule

CMS’s proposed Medicare home health PPS (HH PPS) rule for CY 2014 would cut payment by 1.5% ($290 million) compared to 2013 levels. This proposed reduction reflects a 2.4% home health payment update, which is more than offset by an ICD–9 grouper refinement and an ACA-mandated rebasing adjustment to the national, standardized 60-day episode payment … Continue Reading

Congressional Committees Seek Input on Post-Acute Care Reforms

On June 19, 2013, the leaders of the House Ways and Means Committee and Senate Finance Committee issued an open call for Medicare post-acute care payment (PAC) reform recommendations. The lawmakers cited their concerns about “the substantial variation in Medicare spending, utilization, quality, and Medicare profit margins within the post-acute sector,” and request information on … Continue Reading

MedPAC Report to Congress on Delivery Reform

The Medicare Payment Advisory Commission (MedPAC) has released its June 2013 Report to the Congress on Medicare and the Health Care Delivery System. The report examines a number of potential ways to reform Medicare, including the following:  Redesigning the Medicare benefit. MedPAC continues to discuss the concept of competitively determined plan contributions (CPC), under which … Continue Reading

CMS Proposes Medicare IPPS and LTCH PPS Rates/Policies for FY 2014

On May 10, 2013, the Centers for Medicare & Medicaid Services (CMS) published its proposed rule updating Medicare inpatient prospective payment system (IPPS) and long-term acute care hospital prospective payment system (LTCH PPS) rates and policies for fiscal year (FY) 2014, which begins October 1, 2013. Comments on the proposed rule will be accepted until … Continue Reading

CMS Proposed Changes to Medicare LTCH Payment Rates and Policies for FY 2014

On April 26, 2013, the Centers for Medicare & Medicaid Services ("CMS") released the proposed update to the Medicare long-term acute care hospital prospective payment system ("LTCH PPS") policies and payment rates for fiscal year ("FY") 2014. The proposed changes would apply to discharges occurring on or after October 1, 2013 through September 30, 2014. CMS will accept comments on the proposed rule until June 25, 2013, and will respond to comments in a final rule to be issued by August 1, 2013. Reed Smith has prepared a Client Alert that provides a summary of the most significant proposed changes to the LTCH PPS in the proposed rule.… Continue Reading

CMS Notice Corrects Hospital Readmissions Data

CMS published a notice on March 13, 2013 correcting previous technical errors to the Medicare inpatient prospective payment systems (IPPS) final rulemaking for FY 2013. Among other things, CMS is correcting statistics on the Hospital Readmissions Reduction Program with regard to (1) the amount by which payments to hospitals would be reduced; and (2) the … Continue Reading

CMS Issues Final Medicare Inpatient Hospital Rates/Policies for FY 2013

On August 31, 2012, the Centers for Medicare & Medicaid Services (CMS) is publishing its final rule to update Medicare inpatient prospective payment system (IPPS) hospital and long-term care hospital prospective payment system (LTCH-PPS) payment and other policies for FY 2013. Overall, CMS estimates that FY 2013 payments to general acute care hospitals for operating … Continue Reading

Hospital Readmissions Reduction Program May Impact Post-Acute Providers

A new Medicare payment policy on readmissions may place more pressure on post-acute providers to coordinate care with the general acute-care hospitals in their community. The Centers for Medicare & Medicaid Services ("CMS") is in the process of adopting a new policy for reducing payments under the inpatient prospective payment system ("IPPS") to those hospitals with high readmission rates for patients with certain conditions. As a result, hospitals paid under the IPPS may incur a payment penalty if a skilled nursing facility ("SNF"), long-term acute care hospital ("LTCH"), inpatient rehabilitation facility ("IRF") or other post-acute care provider transfers a patient or resident back to the hospital for additional inpatient services. This policy change provides a powerful incentive to coordinate care and standardize procedures across providers.… Continue Reading

CMS Seeks Applicants for ACA Bundled Payment Initiative

The Centers for Medicare & Medicaid Services (CMS) has launched the Bundled Payments for Care Improvement Initiative under Section 3021 of the Affordable Care Act (ACA), which authorizes the Secretary to test innovative delivery arrangements to reduce federal spending while preserving or enhancing the quality of care. Under the Bundled Payments Initiative, CMS seeks applicants who … Continue Reading

CMS Issues Final Medicare Inpatient Hospital PPS Rule for FY 2012

CMS has released its final rule to update Medicare inpatient prospective payment system (IPPS) hospital and long-term care hospital prospective payment system (LTCH-PPS) payment and other policies for FY 2012.¬†¬† The official version of the rule will be published on August 18, 2011.¬†Overall, CMS estimates that FY 2012 payments to general acute care hospitals for … Continue Reading

CMS Proposes Medicare Inpatient Hospital/LTCH Payment Policies for FY 2012

On May 5, 2011, the Centers for Medicare & Medicaid Services (CMS) is publishing its proposed rule to update Medicare inpatient prospective payment system (IPPS) hospital and long-term care hospital prospective payment system (LTCH-PPS) payment and other policies for FY 2012. Overall, CMS estimates that FY 2012 payments to general acute care hospitals for operating … Continue Reading

CMS Open Door Forum on “Partnership for Patients: The Community-Based Care Transitions Program” (May 5)

On May 5, 2011, CMS is hosting a national forum on the ACA-mandated Community-Based Care Transitions Program (CCTP). The CCTP is designed to encourage the development of partnerships between hospitals with high readmission rates and community based organizations in order to: improve transitions of beneficiaries from the inpatient hospital setting to other care settings; improve … Continue Reading

HHS Launches $1 Billion Partnership for Patients to Improve Hospital Care

On April 12, 2011, HHS Secretary Kathleen Sebelius and CMS Administrator Donald Berwick launched a public-private “Partnership for Patients” to improve hospital care and transitions between care settings and reduce health system costs. By the end of 2013, the Partnership is committed to: (1) reducing preventable hospital-acquired conditions by 40% compared to 2010 levels; and (2) decreasing preventable … Continue Reading

CMS Conference on ACA Community-Based Care Transitions Program (Reducing Hospital Readmissions)

On December 3, 2010, CMS is hosting a public forum on the upcoming Community-Based Care Transitions Program, which was authorized by the Affordable Care Act to reduce hospital readmissions, test sustainable funding streams for care transition services, maintain or improve quality of care, and document measureable savings to the Medicare program. The registration deadline for in-person … Continue Reading
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