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policy

America's Essential Hospitals called on CMS to provide an adequate annual payment update to cover the effects of inflation and rising workforce costs.

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Essential Insights

Time-driven activity-based costing measures the use of staff time and materials at each step of delivering medical services and can help hospitals save.

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policy

The rule includes changes to the calculation of Medicare disproportionate share hospital payments and payment and quality reporting provisions.

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policy

CMS says the withdrawal of the mandate, effective immediately, aligns with the agency's approach to other infectious diseases.

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policy

Hospitals have until June 1 to preview their Overall Hospital Quality Star Rating, measure group score, individual measure results, and peer grouping.

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policy

The proposal includes numerous policy and payment changes to Medicare’s Inpatient Prospective Payment System for fiscal year 2024, including a 2.8 percent increase in inpatient payment rates.

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policy

The updated guidance highlights the importance of sustaining a QAPI program over time and increasing engagement by the hospital’s governing body.

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policy

America's Essential Hospitals urges CMS to swiftly restore full Medicare Part B drug payment rates for hospitals in the 340B Drug Pricing Program and define a select group of hospitals with a safety net mission.

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policy

The association urged CMS to adequately reimburse off-campus, provider-based departments; refine physician quality reporting; and codify a definition of essential hospitals.

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policy

Health care providers have until Aug. 30 to download their preview reports before CMS shares quality data publicly in October.

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policy

This is the second star ratings update since the agency updated its methodology in 2020 to include the use of peer grouping.

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policy

Hospitals have until June 16 to preview their Overall Hospital Quality Star Rating, measure group score, and individual measure results, along with peer grouping.

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policy

The action plan includes goals to close gaps in health care access, quality, and outcomes through data collection, outreach, and community engagement.

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policy

The proposed fiscal year 2023 Inpatient Prospective Payment System rule would increase operating payment rates by 3.2 percent and make other changes to Medicare payment and quality reporting policies. CMS is accepting comments on the proposed rule until June 17.

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policy

Recommendations for Medicare and Medicaid equity measures under development focus on standardized data collection and opportunities for testing and feedback.

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policy

The Center for Medicare & Medicaid Innovation will release a request for applications for the Realizing Equity, Access, and Community Health accountable care organization model, which will focus on promoting health equity and mitigating health disparities for underserved communities.

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policy

Due to a calculation error in measure results used for calendar year 2021 public reporting, the Centers for Medicare & Medicaid Services has delayed until July the overall hospital star ratings update originally scheduled for April.

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policy

Final rules for Medicare’s OPPS and PFS for CY 2022 continue Medicare Part B drug payment cuts to hospitals in the 340B Drug Pricing Program; continue site-neutral payment policies; and halt elimination of the inpatient-only (IPO) list.

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policy

In response to the calendar year 2022 Outpatient Prospective Payment System proposed rule, America's Essential Hospitals urged CMS to halt elimination of the inpatient-only list and to restore adequate payment to hospitals in the 340B program and to off-campus provider-based departments.

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policy

CMS on Aug. 2 released its fiscal year 2022 Inpatient Prospective Payment System final rule, which includes payment and quality reporting provisions. The rule does not finalize provisions related to new residency slots, organ acquisition costs, or Section 1115 waiver days. 

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policy

America's Essential Hospitals commented on several policy proposals of interest to essential hospitals in the Inpatient Prospective Payment System rule and responded to a request for information on closing the health equity gap in hospital quality programs.

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policy

The Centers for Medicare & Medicaid Services published updated overall hospital quality star ratings on its Care Compare website; the ratings were last updated in January 2020. America's Essential Hospitals has expressed continued concern about the fairness and reliability of the ratings.

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policy

The Centers for Medicare & Medicaid Services’ proposed fiscal year 2022 Inpatient Prospective Payment System rule would increase operating payment rates by 2.8 percent, repeal market-based data collection, and add 1,000 new graduate medical education teaching slots, among other provisions.

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policy

Hospitals have 30 days to review their reports before public reporting to Care Compare.

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policy

The Centers for Medicare & Medicaid Services (CMS) on Dec. 1 will retire its original Hospital Compare tools, encouraging users to visit Medicare.gov’s new Care Compare tool to find and compare health care providers. CMS will not update the overall hospital quality star ratings in January 2021.

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quality

CMS encourages hospitals to download and save historical reports from the Hospital Quality Reporting system before the reports are removed on Dec. 15.

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policy

New email inboxes set up by the Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) will take questions about the updated guidance for hospital COVID-19 data reporting requirements as part of Medicare conditions of participation.

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policy

The proposed rules would deepen Medicare Part B cuts to hospitals in the 340B Drug Pricing Program, continue site-neutral payment policies, and revise the overall hospital star rating methodology. The association urged CMS to protect funding for essential hospitals and access to care.

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policy

Policies finalized for the 2021 Medicare Inpatient Prospective Payment System call for increasing inpatient payment rates by 2.9 percent, reducing Medicare disproportionate share hospital payments, and collecting median Medicare Advantage charge data.

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policy

Care Compare merges the agency's eight health care provider comparison tools into one interface; price and provider data are now available through an application programming interface.

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policy

The Centers for Medicare & Medicaid Services in an interim final rule announced new Medicare condition of participation requirements for hospitals to report COVID-19 cases and related data to the Department of Health and Human Services.

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policy

A new report, from a National Quality Forum (NQF) 25-person technical expert panel, provides insight on how quality measures can be combined in a system to improve health outcomes and drive high-value care for all.

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policy

The Medicare Outpatient Prospective Payment System proposed rule for calendar year 2021 would deepen cuts to hospitals in the 340B Drug Pricing Program, continue cuts to off-campus provider-based departments, and update the overall hospital star ratings methodology.

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policy

In this second report on the topic, the agency describes three findings: there is no systematic or standard collection of social risk data; dual enrollment in Medicare and Medicaid remains a predictor of poor outcomes; and there are limited efforts to identify effective and scalable interventions.

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policy

The Centers for Medicare & Medicaid Services released its proposed fiscal year 2021 Inpatient Prospective Payment System rule, which includes payment and quality reporting provisions.

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policy

CMS releases guidance for hospitals in quality reporting programs; CDC updates guidelines for testing and handling COVID-19 specimens.

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policy

CMS issues elective surgery guidance, telehealth toolkits, and information on quality reporting flexibility amid the COVID-19 pandemic; The Joint Commission suspends regular surveys.

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policy

CMS plans to transition to a unified Medicare Care Compare portal this spring that will combine and standardize the eight existing tools and allow a single point of entry for quality information.

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policy

This month’s data refresh is based on the existing, flawed methodology used during the last update of star ratings in February 2019.

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Health care consumers need accurate, relevant information to make the best care decisions; the current star ratings do not meet this need. The ratings rely on a methodology that fails to account for differences among hospitals and, therefore, could mislead rather than inform consumers.

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institute

Researchers studied 3,608 hospitals nationwide, examining the associations between neighborhood social risk factors and seven CMS quality domains.

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Essential Insights

Essential hospitals are committed to transparent, accurate quality measurement, but a single hospital star rating oversimplifies a complex and personal decision.

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policy

A new brief summarizes program recommendations from an expert panel, which included America's Essential Hospitals staff.

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policy

The October refresh does not include an update of overall star ratings, which were last updated in February.

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webinar

Gain strategies to identify improvement areas, benchmarking methodologies to measure opportunity, and measurement tools your hospital can use to reduce care variation.

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policy

The final rule revises conditions of participation and conditions for coverage and also targets emergency preparedness, quality reporting, infection control, and physical examination requirements.

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policy

An NEJM Catalyst article assesses four public hospital quality reporting programs' ability to classify hospital performance.

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policy

The agency plans to update the Overall Hospital Quality Star Ratings methodology in 2021 and will host a Sept. 19 listening session to seek stakeholder feedback.

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policy

America’s Essential Hospitals urged the Centers for Medicare & Medicaid Services to reduce administrative burden regarding clinical documentation, health information technology, and public health reporting.

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policy

The refresh includes results from the Hospital Consumer Assessment of Healthcare Providers and Systems but does not include overall star ratings.

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policy

The calendar year 2020 proposed rule includes updates to the Quality Payment Program, a request for information on the creation of Merit-based Incentive Payment System Value Pathways, and other topics of interest to essential hospitals.

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webinar

This webinar will introduce the AHRQ EPC Program and its evidence reviews and provide examples of how these reviews benefit hospitals and health systems.

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state-action

The Centers for Medicare & Medicaid Services has refreshed data for the Medicaid and Children’s Health Insurance Program Scorecard, which reflects states’ progress in strengthening their reporting of patient health outcomes.

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policy

Hospitals in the Inpatient Quality Reporting, Prospective Payment System–Exempt Cancer Hospital Quality Reporting, and Hospital Outpatient Quality Reporting programs can view their preview reports through Aug. 14.

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policy

America’s Essential Hospitals encouraged the Centers for Medicare & Medicaid Services to consider the disproportionately negative financial effect on essential hospitals of certain quality reporting requirements and administrative burden in the Promoting Interoperability Programs.

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state-action

A recent issue brief profiles states that use data to identify and reduce health disparities in Medicaid managed care programs and offers a step-by-step strategy for states interested in similar initiatives.

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policy

The Primary Cares Initiative comprises five new voluntary payment model options under two paths. The new models build on the experience of the Medicare Shared Savings Program and Next Generation Accountable Care Organization model.

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policy

A new proposed rule would increase inpatient operating payment rates by 3.2 percent and make other changes to Medicare payment and quality reporting policies. CMS is accepting comments on the proposed rule until June 24.

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policy

Hospitals in the Inpatient Quality Reporting, Prospective Payment System–Exempt Cancer Hospital Quality Reporting, and Hospital Outpatient Quality Reporting programs can view their preview reports through May 21.

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policy

America’s Essential Hospitals encouraged the Centers for Medicare & Medicaid Services to suspend publication of the overall hospital quality star ratings until the agency addresses issues with the underlying methodology.

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policy

The report includes recommendations on several issues of importance to essential hospitals, including hospital inpatient and outpatient services, hospital quality incentive programs, and alternatives to opioids.

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policy

Hospitals now have until March 14 to submit data for the Medicare Promoting Interoperability and Hospital Inpatient Quality Reporting (IQR) programs.

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policy

The agency posted potential changes to the star ratings program for public comment, including potential hospital peer grouping.

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policy

Hospitals have until Dec. 30 to preview their quality data before it is published on the Hospital Compare website in February 2019.

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policy

The agency will hold educational webinars to help health care providers understand the new user interface for Hospital Compare preview reports.

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policy

The rule includes updates to the Quality Payment Program and documentation and payment changes for evaluation and management services.

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policy

The agency will publish accrediting organization (AO) performance data, redesign AO validation surveys, and share its annual report to Congress.

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quality

Health care providers can use this interactive tool to compare performance among states, identify areas for improvement, and find models for best practices.

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policy

Cooperative agreements with seven organizations aim to develop, improve, update, or expand quality measures for Medicare’s Quality Payment Program.

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policy

America’s Essential Hospitals urged the Centers for Medicare & Medicaid Services to reverse policies that will result in significant funding cuts to essential hospitals and hinder access to care.

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policy

Elements of the proposal of interest to essential hospitals include targeting emergency preparedness, hospital quality program requirements, infection control, and physical examinations.

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policy

Essential hospital staff are invited to provide feedback on overall hospital quality star rating methodology during an Oct. 4 listening session; the Centers for Medicare & Medicaid Services will use the feedback to inform future methodology updates.

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policy

Hospitals have until Aug. 25 to preview their quality data before publication on the Hospital Compare website in October.

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policy

In the rule, the Centers for Medicare & Medicaid Services continues a policy of reduced payments to new off-campus provider-based departments; the agency also provides updates to the Quality Payment Program.

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policy

The Centers for Medicare & Medicaid Services extended to Aug. 8 the participation agreement deadline for the Bundled Payments for Care Improvement Advanced model and announced that participants can retroactively withdraw from the program in March 2019.

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webinar

Hear how experts at Carilion Clinic created a Quality Performance Indicator Database to standardize and disseminate data and reduce preventable harm.

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policy

Responding to concerns raised by America’s Essential Hospitals and other stakeholders, the Centers for Medicare & Medicaid Services has announced it will postpone the July public release of overall hospital star ratings.

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The agency says postponing the July release will allow additional time to analyze the impact of changes to some measures.

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policy

Hospitals have until June 2 to preview their quality data before it is published on the Hospital Compare website in July.

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policy

The refresh includes data for the Hospital Inpatient Quality Reporting, Prospective Payment System–Exempt Cancer Hospital Quality Reporting, and Hospital Outpatient Quality Reporting programs.

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policy

Providers who submitted data through the Quality Payment Program website can review preliminary performance feedback. Final scores and feedback will be available July 1.

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policy

A new analysis suggests specialty hospitals receive higher star ratings from the Centers for Medicare & Medicaid Services than major teaching hospitals by reporting fewer quality measures.

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policy

The new resources for Medicare-eligible hospitals and critical access hospitals include details about submitting data through QualityNet and information on clinical quality measures.

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policy

The Measure Applications Partnership Hospital Workgroup recommended greater alignment of measures across programs and proposed criteria for measure removal.

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policy

The Measure Applications Partnership submitted recommendations to the Department of Health and Human Services on 35 performance measures under consideration for use in federal health care programs.

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policy

Hospitals have until March 2 to preview their quality data before it is published on the Hospital Compare website in April.

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policy

The Centers for Medicare & Medicaid Services will review December 2017 methodology enhancements and their impact on star ratings in a Nov. 30 webinar.

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policy

The rule includes additional cuts to new off-campus, provider-based departments (PBDs), as well as physician payment and quality program changes.

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policy

The rule cuts 340B Drug Pricing Program payments by $1.6 billion and requires hospitals to use modifiers to identify 340B drugs in Medicare claims.

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policy

The quality measure data update excludes Hospital Compare overall star ratings, which will refresh beginning Nov. 3.

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policy

Hospitals have until Oct. 31 to preview their quality data; CMS hospital-specific preview reports for overall quality star ratings will be available to hospitals in mid-October.

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policy

America's Essential Hospitals was among those urging the agency to suspend overall star ratings and examine concerns with the methodology.

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policy

The committees were convened at the direction of the Department of Health and Human Services and include representatives from members of America’s Essential Hospitals.

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policy

Affected providers will be exempt from reporting provisions of the Medicare Hospital Outpatient Quality Reporting Program, Hospital Inpatient Quality Reporting Program, and Ambulatory Surgical Center Quality Reporting Program.

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policy

The Centers for Medicare & Medicaid Services is granting exceptions under certain Medicare quality reporting and value-based purchasing programs to hospitals and health care facilities in Federal Emergency Management Agency–designated major disaster counties.

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policy

The changes include optimizing the assignment of star categories, eliminating the removal of outliers, and ensuring only hospitals meeting public reporting thresholds are assigned star ratings.

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webinar

This webinar explored how technology demands and a safety-net mission influence other measures of hospital quality, safety, cost, and value.

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policy

The new rule would affect inpatient operating payments, Medicare disproportionate share hospital payments, and the Hospital Readmissions Reduction Program.

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policy

The Hospital Compare refresh includes data on new measures; hospitals can preview their overall star ratings through Aug. 13.

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policy

Of the 303 performance measures submitted during the trial period, 65 were determined to have a conceptual basis for adjustment for social risk factors.

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policy

The Medicare Physician Fee Schedule proposed rule for calendar year 2018 includes physician payment and quality program changes.

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policy

CMS proposes changes related to participation in the merit-based incentive payment system or Advanced Alternative Payment Models tracks.

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policy

America’s Essential Hospitals encourages CMS to improve transparency, risk adjust, and reduce regulatory burden for essential hospitals.

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policy

Overall star ratings now will be released in October because of issues with data on three measures; hospitals can preview the ratings in July.

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policy

The update for the 2018 performance year aligns electronic clinical quality measure specifications with current clinical guidelines and code systems.

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policy

CMS updated the Hospital Compare website with new data, including health care–associated infections and HCAHPS survey data.

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webinar

How experts at UChicago Medicine are advancing health equity through their CLAS standards assessment and strategic plan.

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policy

Hospitals have until May 5 to review overall Hospital Compare star rating and until May 10 to review value-based purchasing hospital-specific reports.

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quality

Of particular note, NQF's Measure Applications Partnership acknowledged the need for more research to understand the role of socioeconomic status in health.

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policy

CMS has extended the deadline for submitting certain hospital quality data after receiving reports of system issues and inaccessibility with QualityNet.

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quality

NQF's Measure Applications Partnership submitted recommendations to HHS on 74 performance measures under consideration for 16 federal health care programs.

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policy

Hospitals now have until March 13 — instead of Feb. 28 — to submit electronic clinical quality measure data from 2016 to CMS.

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policy

The changes, which reflect stakeholder feedback and the large volume of changes to ICD-10 in FY 2017, will be available on the National Library of Medicine’s Value Set Authority Center this month.

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quality

The report finds that dual enrollment status was “the most powerful predictor of poor outcomes” on many quality measures.

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policy

CMS on Dec. 19 refreshed its Hospital Compare site, including data on the Ambulatory Surgical Center Program, Hospital Readmission Reduction Program & more.

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policy

Hospitals can request an exemption from the electronic clinical quality measure reporting requirement in the Hospital Inpatient Quality Reporting Program.

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policy

The agency released software that will help developers build applications for clinicians and their practices and make it easier for organizations to retrieve and maintain QPP measures using the Explore Measures section of the QPP website.

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policy

Of particular interest to members of America’s Essential Hospitals are changes to the Medicare Shared Savings Program and provisions related to telehealth.

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webinar

Learn how Eskenazi Health’s Pain School couples psychological and physical rehabilitation to improve patient outcomes

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quality

Starting in 2017, the National Quality Forum's Consensus Standards Approval Committee will make final decisions on endorsements without board approval.

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policy

CMS Acting Administrator Andrew Slavitt announced the reporting options providers have to ensure they do not face a negative payment adjustment in 2019.

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policy

CMS encourages hospitals to view overall star ratings reports with inpatient and outpatient quality reporting preview data, while both are available.

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policy

The release comes after America’s Essential Hospitals and other hospital groups urged CMS to delay the ratings due to serious concerns with the methodology.

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quality

The report aims to identify social risk factors that affect beneficiaries' health outcomes and methods to account for these factors in payment programs.

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policy

The rule, released July 7, updates physician payment rates for Medicare services and makes changes to physician quality programs.

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policy

America’s Essential Hospitals and other hospital groups urge CMS to continue to delay the public release of overall hospital quality star ratings, arguing that the rating methodology is opaque and flawed.

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quality

Agency will use measure to calculate the proportion of adult patients with active, concurrent prescriptions for opioids or for an opioid and benzodiazepine at discharge.

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quality

The HAC reports might have contained the incorrect hospital name in one table. CMS will distribute new reports to affected hospitals.

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policy

Hospitals have until June 4 to preview reports on overall Medicare star ratings, which will be publicly posted to Hospital Compare in July.

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America's Essential Hospitals statement on the Centers for Medicare & Medicaid Services' decision to delay the release of overall hospital star ratings.

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policy

Responding to hospital and other stakeholder concerns, CMS says the delay will allow a greater opportunity to fully understand the impact of the final star ratings methodology.

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institute

Updated: Annals of Surgery article covering the impact of patient socioeconomic status on operative mortality.

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quality

Hospitals that perform well in quality programs—despite serving high levels of vulnerable patients—invest in health equity, data, collaborative partnerships, patient engagement, and more.

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policy

Material note association concerns about, and help members prepare for, April 21 public release of Hospital Compare star ratings.

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webinar

Learn how one hospital's quality transparency initiative is helping to meet the public's growing demand for information.

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webinar

Prepare for the April 21 public release of Medicare Hospital Compare five-star ratings.

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policy

In comments to CMS, America's Essential Hospitals argues for a delay to re-evaluate ratings methodology changes and the potential to disproportionately disadvantage essential hospitals.

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quality

Guidance on the new sepsis measure (SEP-1) is now available on QualityNet, including what documentation can be used for data elements in the chart-abstracted measure.

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policy

New clinical quality measure sets for physicians were created in collaboration with stakeholders to increase multipayer alignment, while reducing cost and administrative burden. The core measure sets will inform the implementation of MACRA.

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policy

State hospital association says risk adjusting CMS readmissions methodology results in significantly less variation in measured quality differences among hospitals.

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quality

Previews of reports, to be published online in April, available now through QualityNet Secure Portal; final methodology includes 60 measures from inpatient and outpatient quality reporting programs.

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policy

First of five consensus reports from National Academy of Medicine (NAM) ad hoc committee identifies social risk factors for Medicare payment and quality programs, and the measures they can impact.

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quality

Educational surveys to help CMS determine best ways to assess infection control regulations for hospitals, nursing homes, and care transitions. Surveys to begin in FY 2016 for nursing homes and in FY 2017 for hospitals.

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policy

Agencies seek information on quality reporting to help reduce the burden on eligible hospitals and providers; comments are due Feb. 1.

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policy

Hospital performance data for FY 2016 available on Hospital Compare; hospitals in bottom quartile face 1 percent Medicare payment cut.

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policy

Hospitals paid under IPPS in 67 metropolitan statistical areas will be required to participate in new payment model starting in April 2016

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policy

Member leaders attend more than 100 meetings with lawmakers and congressional staff as part of fall Policy Assembly. Event also included insights from policymakers and a Capitol Hill reception honoring 2015 Gage Award recipients.

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policy

Feedback due Nov. 17 on provisions to implement MIPS and APM participation incentives; MIPS quality measures of particular interest to hospitals

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policy

Updates cover exclusions for submitting electronic immunization data and applicability of submitting summary of care documents for transferring patients.

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