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

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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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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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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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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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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

A proposed rule from CMS includes numerous changes for Medicare’s Inpatient Prospective Payment System for fiscal year 2022, including a 2.8 percent increase in inpatient payment rates and updates to quality reporting programs and the Medicare Shared Savings Program.

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

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

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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

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

Both chambers passed a bill providing more than $8 billion to combat the new coronavirus; House leaders now are discussing legislation to mitigate economic impacts associated with the virus. A Senate letter calling to incorporate social determinants into hospital star ratings closes tomorrow.

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policy

Congressional leaders are holding several hearings to inform their COVID-19 response and negotiating legislation that could provide up to $8 billion in emergency supplemental funding to respond to the outbreak.

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HHS Secretary Alex Azar will discuss the president's proposed fiscal year 2021 budget at several congressional hearings. A bipartisan Senate letter calls for incorporating social determinants into star ratings. A new association work group focuses on the Medicaid Fiscal Accountability Regulation.

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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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policy

The final rules for Medicare’s Outpatient Prospective Payment System and Physician Fee Schedule for calendar year 2020 also expand access to opioid use disorder treatment and establish a prior authorization process for certain services.

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Health care providers have until Dec. 3 to download their preview reports, which include overall hospital quality star ratings.

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Facilities located in areas designated as emergency or major disaster areas will be exempt from provisions of Medicare quality reporting programs.

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

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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

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

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America’s Essential Hospitals and three other national hospital groups urged the Centers for Medicare & Medicaid Services to postpone its February publication of overall hospital star ratings.

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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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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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The Medicare Outpatient Prospective Payment System final rule for calendar year 2019 broadens the scope of cuts to hospitals in the 340B Drug Pricing Program and to off-campus provider-based departments; in a statement, the association strongly objected to these additional payment cuts.

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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

A new proposed rule for Medicare’s Outpatient Prospective Payment System would broaden the scope of cuts to hospitals in the 340B Drug Pricing Program and to off-campus provider-based departments; it also contains provisions related to quality reporting and transparency.

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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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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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The reports provide estimated hospital-level proportions of dual-eligible patients, peer group assignments, and payment adjustment information using the program's new stratified methodology.

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Group reporting through the Centers for Medicare & Medicaid Services web interface must be completed by March 16; all other Merit-based Incentive Payment System data must be submitted by March 31.

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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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Merit-based Incentive Payment System–eligible clinicians and groups may apply for hardship exceptions due to connectivity issues or extreme circumstances, such as disasters.

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The proposed rule would further cut payments to non-excepted provider-based departments to 25 percent of the Medicare Outpatient Prospective Payment System rate and change certain quality reporting requirements.

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Exceptions are available for Merit-based Incentive Payment System eligible clinicians and groups that experienced insufficient internet connectivity, uncontrollable circumstances, or other issues; applications are due Oct. 1.

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policy

Clinicians enter their national provider identifier into the tool to determine whether they must submit data to the merit-based incentive payment system.

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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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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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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

Under the rule, CMS would increase the OPPS payment rate by 1.65 percent and provide flexibility in the meaningful use of EHRs, among other things.

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policy

Hospitals and eligible professionals now can register to submit National Health Care Survey data in 2017.

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quality

Hospitals and other providers generated more than $466 million in savings in 2015 through participation in Medicare accountable care organizations (ACOs).

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policy

The rule includes the annual payment update to inpatient payment rates and changes to the Medicare disproportionate share hospital payment methodology.

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policy

The agency analyzed how subsets of hospitals, including those defined as a safety net, performed in the overall hospital star rating system.

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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 overall star rating hospital-specific reports will be available to hospitals for 30 days, starting from the June 22 reload date.

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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

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

Eligible hospitals have until Dec. 31 to submit data through QualityNet for the Inpatient Quality Reporting and Medicare Electronic Health Record Incentive programs.

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institute

Essential hospitals 2.67 times more likely than other hospitals to receive penalties under Medicare readmissions program in FY 2016

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policy

Agency to host Nov. 30 webinar to provide information and answer questions about the bundled payment model for hip and knee replacement.

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policy

Changes include reducing OPPS payment by 0.3 percent, relaxing two-midnight policy requirements, and updating OQR measures.

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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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quality

Oct. 20 call to discuss dry run quality report for inpatient rehabilitation facilities based on the all-cause unplanned readmission measure

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quality

These findings come from GAO, which also found that essential hospitals narrowed this gap over the study, overall performance during VBP's initial years didn't change, and bonuses and penalties were less than 0.5 percent of Medicare payments per year.

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policy

CMS requests feedback on a range of provisions relating to MIPS and incentives for participation in APMs, including whether to stratify quality measure data by demographic factors.

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policy

The briefing included a panel of four experts serving different Medicaid populations who spoke about continuing to strengthen the program and the role of Medicaid expansion in increasing access to care.

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quality

Reports previously excluded the first six months of 2014 data on SSIs, which may have impacted payment adjustment and quality measure results. CMS has opened a second review and correction period.

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quality

The dry run reports are for a new claims-based outcomes measure that will be included in the IQR Program starting in fiscal year 2018. Hospitals have until Oct. 7 to access this report through QualityNet.

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quality

Association calls on CMS to consider the readiness of essential hospitals and challenges of caring for the vulnerable, and risk-adjust for SDS, in finalizing its proposed rule for new CCJR payment model.

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policy

In comments on the CY 2016 OPPS proposed rule, the association calls on CMS to consider the unique challenges of caring for the most vulnerable, including in relation to the two-midnight policy and ambulatory payment classification.

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quality

CMS is proposing to risk adjust stroke mortality measures for stroke severity, which is a positive step. But measures should also account for sociodemographic factors that complicate care for vulnerable patients.

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quality

Pioneer and MSSP ACOs showed improvement in at least 27 of 33 quality measures in last reporting period. More than 420 Medicare ACOs have been established, coordinating care for more than 7.8 million patients.

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quality

The program will be re-evaluated, as changes to quality measures, including the transition to eCQMs and movement away from chart-based measures, has made it difficult to compare hospitals and identify top performers.

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policy

Comments call on CMS to ensure ratings are meaningful and accurate, avoid consumer confusion, and reflect vulnerable patients' socioeconomic and demographic circumstances.

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policy

Extension to Aug. 28 applies only to quality reporting on health care-associated infections (HAIs), not clinical data submissions through QualityNet.

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policy

America's Essential Hospitals joins other associations in calling for final action on a 90-day reporting period for 2015, but warns that the delay in a final rule has made other requirements impossible to achieve.

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Hospitals in the overall quality rating system dry run can provide feedback until Aug. 17 and weigh in during the Aug. 13 call.

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policy

Comments urge CMS for flexibility, the allowance of certain direct payments, and regulations that reflect states' ability to achieve broader policy goals through the Medicaid Program.

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policy

Hospitals participating in CMS' dry run of its new overall quality rating system are encouraged to provide feedback and ask questions via email and during the Aug. 13 call.

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policy

Proposed CCJR model would bundle Medicare payments to acute care hospitals for hip and knee replacement surgery in 75 metropolitan statistical areas; hospitals would be held financially accountable for meeting quality and cost targets for entire episode of care.

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policy

The June 24 call will discuss methodology for the overall star rating, hospital-specific reports, and lessons learned from testing.

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policy

The call will discuss updates to electronic clinical quality measures (eCQMs) used in quality reporting programs and the impact of their implementation for providers and quality leaders.

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policy

May 29 webinar will focus on quality reporting program proposals, impact of changes to HAC Reduction Program and Hospital Readmissions Reduction Program.

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policy

The model saved $384 million over a two-year time period and is the first alternative payment pilot to meet criteria for expansion to additional sites.

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quality

The updates are for 2016 pay-for-performance programs to improve alignment with the latest clinical guidelines.

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quality

The national provider call will cover alignment and goals for a number of Medicare pay-for-performance programs, including the Inpatient Quality Reporting Program and the Value-Based Purchasing Program.

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quality

IOM recommended a set of 15 core measures to be used across federal quality reporting programs to reduce the administrative reporting burden, allow for nationwide comparisons, and more.

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quality

Inpatient rehabilitation and long-term acute care facilities must submit data to the NHSN on select infections and influenza vaccinations.

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quality

CMS added five-star quality ratings based on the HCAHPS patient satisfaction survey to its Hospital Compare website.

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policy

America's Essential Hospitals President and CEO, other Partnership for Medicaid co-chairs, call partnership proposal the answer to lack of comprehensive, standardized reporting framework

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policy

National impact assessment finds 95 percent of 119 studied quality measures improved during the 2006 to 2012 study period

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institute

Findings suggest variation among four national hospital ratings systems decreases value to consumers and providers

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institute

Brief finds that hospitals with more than 400 beds, teaching hospitals, those treating complex patients, and essential hospitals more likely to receive penalties; no evidence that penalties align with outcomes

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policy

Hospitals must prove meaningful use in 2014 to receive a 2014 incentive payment and avoid a 1 percent payment adjustment in 2016.

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policy

The national provider call will be held Wednesday, Oct. 8, 1:30 – 3 pm ET.

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policy

Congress concluded business until after the Nov. 4 election, passing legislation to fund the government through Dec. 11. Bills funding children's health services and addressing postacute care quality were also sent to the president's desk.

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Essential Insights

Recent work by National Quality Forum to adjust quality and performance measures for social determinants of health of particular significance to essential hospitals, which disproportionately care for sicker, more complex patients

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policy

Ratings will start with the April 2015 release of Hospital Compare data. Dry run will occur between Sept. 15 and Oct. 14.

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policy

The association sent a support letter to House Energy and Commerce ranking members commending their effort to extend CHIP through FY 2019. The proposed legislation would also extend Medicaid primary care payments and bolster quality measures.

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policy

Data collection for a chart-abstracted sepsis measure is delayed until further notice based on an NQF recommendation.

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CMS is compiling three TEPs to provide technical input to CMS contractors on the development, selection, and maintenance of quality measures. Nominations are due Sept. 12 and Sept. 19.

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policy

Interactive resource for eligible hospitals participating in the Medicare Electronic Health Care Record (EHR) Incentive Program will help hospitals report clinical quality measures for 2014.

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policy

Data entry deadline has passed, contact National Healthcare Safety Network help desk for questions or assistance

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policy

NQF board adopts recommendation to assess sociodemographic risk adjustment of certain quality measures during a trial period.

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policy

MAP released a draft report reviewing the core set of health care quality measures for adults enrolled in Medicaid and is accepting comments until July 30.

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policy

CMS will introduce star ratings to Hospital Compare, Dialysis Facility Compare, and Home Health Compare as part of an effort to make information on quality of care easier to understand and compare.

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CMS is inviting interested stakeholders to review and comment on a hospitalwide all-cause unplanned readmission hybrid electronic clinical quality measure.

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CMS seeks perspectives on strengths and weaknesses of the program and processes surrounding data accuracy.

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Acute care facilities that participate in the Hospital Inpatient Quality Reporting Program must enter Medicare beneficiary numbers on event records for all Medicare patients into the National Healthcare Safety Network, beginning July 1.

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policy

The bill would require the Centers for Medicare & Medicaid Services to consider socioeconomic status of hospital patient populations in its calculation of penalties under the Hospital Readmissions Reduction Program.

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policy

CMS has released a call for feedback on the June 10 draft quality reporting document architecture guide for eligible professionals and hospitals to use for 2015 clinical quality measure reporting. Feedback is due June 27.

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policy

A nationwide survey of adult Medicaid enrollees will be conducted this fall. Results will identify state-specific and nationwide measures of health care access, barriers to care, satisfaction with providers, and patient experiences with Medicaid managed care and fee-for-service providers.

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policy

CMS is urging hospitals to register soon for the QualityNet Secure Portal to ensure access on July 1 to meet reporting requirements for the Hospital Inpatient Quality Reporting and Hospital Outpatient Quality Reporting Programs.

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policy

CMS issued a final rule Friday, May 16, on 2015 standards for health insurance marketplaces and the insurance market. Among other provisions, CMS finalized measures for a quality rating system that would require health insurance issuers operating through the marketplaces to collect, validate, and report data on quality metrics for qualified health plans.

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policy

The association said that CMS should implement the QRS in a way that protects consumer access to ECPs in the marketplaces. It also urged CMS to ensure the measures used in the QRS are endorsed by the National Quality Forum and risk adjusted for socioeconomic factors.

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policy

America's Essential Hospitals supports NQF's recommendations to adjust some health care performance measures for sociodemographic factors.

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policy

Starting July 1, IQR and OQR data must be submitted through the secure portal. CMS encourages hospitals to enroll in the portal and complete the identity proofing process by May 1.

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policy

The measure, OP-31/ASC-11, is part of the ASC Quality Reporting Program and the OQR Program. Data collection, which was scheduled to begin April 1, will now begin Jan. 1, 2015. America's Essential Hospitals successfully encouraged CMS to delay the measure, arguing the measure was not properly tested for the ASC and outpatient settings.

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policy

As part of the meaningful use program, participating hospitals must report data for eCQMs that cover three of six National Quality Strategy domains. The original eCQM specifications were released in 2012 and are updated annually.

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quality

A recent National Quality Forum draft report discusses whether performance measures used in accountability applications, such as pay-for-performance or public reporting, should be adjusted for socioeconomic factors when determining results; share your comments.

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policy

CMS proposes that QHP issuers collect enrollee satisfaction data for certain QHPs. This data will be one of the components used to determine QHP quality ratings. America's Essential Hospitals will submit comments on CMS' proposal for collecting enrollee satisfaction data.

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policy

NQF makes eight recommendations to enhance the ability of policymakers and consumers to make accurate conclusions about the quality of care and prevent unintended consequences, such as a worsening of care disparities. Members are encouraged to submit comments by April 16.

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policy

The proposal calls for a common, mandatory set of Medicaid quality measures to be reported by all states. Panelists discussed the importance of the Medicaid program and the need strengthen and improve it.

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policy

NQF recommends adjusting some health care performance measures to account for sociodemographic risk factors. Members are encouraged to submit comments on the draft recommendations by April 16.

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policy

CMS will host a National Provider Call March 18, from 1:30 to 3 pm Eastern time, on 2014 Medicare quality reporting programs. During the call, officials will provide an overview of how to report quality measures in various Medicare programs, including those for electronic health records incentives and accountable care organizations.

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policy

Starting July 1, IQR and OQR data must be submitted through the secure portal. CMS encourages hospitals to enroll in the Secure Portal and complete the identity proofing process by May 1.

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policy

CMS says all 32 pioneer ACOs improved quality, performed better than published rates in fee-for-service Medicare

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policy

Rule includes proposed formula to make Medicare DSH reductions under ACA

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