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February 9, 2016

Posts in "Hospitals"

March 20, 2015

Hospitals Press for Relief From Medicare Readmission Penalty

While pressing for relief from a penalty tied to readmission rates, hospital executives showed how the Medicare policy is spurring a deeper look at how some of the poorest Americans live.

The American Hospital Association briefed congressional staff Thursday about its bid to change the penalty policy, which it is seeking to attach to a measure that designed to prevent a cut in Medicare payments to doctors.

About 2,600 hospitals faced fines related to relatively high readmission rates for certain conditions in fiscal 2015, with penalties totaling about $428 million, according to the AHA.

Hospital officials contend that Medicare should factor in the socioeconomic status of patients served when assessing the readmission fee for hospitals. The penalty, created by the 2010 health law, is leading hospitals to more carefully consider what happens to patients after they are discharged for select common conditions, such as heart failure and heart attacks.

“They honestly may not have somewhere to go that night when you discharge them,” said Rachel George of Illinois’ Presence Health. “They certainly may have to make choices about whether they pick up their medication or they are going to eat, or if they are going to pick up their medications or if they are going to stand in line for a shelter.”

Her hospital network is trying to help patients avoid readmissions with steps such as providing 30 days worth of medication, she said.

In the end, though, there is only so much that hospitals can control, she said.

“To penalize hospitals because we cannot solve the socioeconomic issues in the communities that we face, that’s a challenge,” she said.

In addition to trying to attach a bill on the readmission penalty to the doc fix measure, the AHA is backing bills (HR 1343, S 688)  that have been introduced in both chambers addressing this issue.

By Kerry Young Posted at 2:01 p.m.

February 20, 2015

Hospital Use of Electronic Health Records on the Rise, CDC Says

The number of hospital emergency departments using electronic health records rose from 46 percent in 2006 to 84 percent in 2011, according to a new analysis by the National Center on Health Statistics.

The number of hospital outpatient departments using an electronic health system rose from 29 percent in 2006 to 73 percent in 2011, according to the NCHS, which is part of the Centers for Disease Control and Prevention.

The findings mirror previous information about the growing use of electronic health records, in large part because providers that participate in Medicare and Medicaid have financial incentives to build electronic health systems that meet certain criteria — and they are penalized if they don’t.

Electronic health records are beneficial in meeting the goals of the Department of Health and Human Services’ move toward a more value-based system rather than one in which payments are based on volume.

January 7, 2015

Study Emphasizes Savings From Hospital Infection Control

Healthcare-associated infections are major concern for hospitals and the worries are compounded when they impact elderly patients. A new Columbia University study released this month examined the impact of infections, which kill more than 75,000 people each year and lead to $33 billion in excess health care costs.

The study, published in the American Journal of Infection Control, examined a group of elderly patients who contracted an infection while in an Intensive Care Unit (ICU). More than half of all the ICU patients died within 5 years of leaving the hospital but patients with an infection were 35 percent more likely to die with in 5 years. The study concluded that preventing healthcare associated infections would also reduce health care costs by nearly $150,000 per patient compared with an estimated cost of a hospital infection control program of $145,000 per year.

By Paul Jenks Posted at 10:43 a.m.

December 16, 2014

Report Examines Options for Improving Hospital Emergency Rooms

Hospital emergency room conditions and operations can be the focal point of early indicators of many health care delivery issues. Emergency rooms provide a large portion of heath care to the country, particularly for uninsured and Medicaid patients. Busy emergency departments are also costly operations for hospitals, which are required by federal law to treat all patients regardless of the patient’s ability to pay.

The Congressional Research Service, in a report published this month, offers a primer for lawmakers on role of emergency rooms in the health care delivery system.  The report also examines other concerns, including emergency room crowding, frequent patient visits, and providing care for persons with behavioral health conditions. CRS suggests a range of options from changing emergency department accreditation requirements and enhancing Medicaid and Medicare reimbursement rates, plus a suggested change to the emergency care law and requiring specialized behavioral health facilities to accept the transfer of patients from overwhelmed emergency rooms.


By Paul Jenks Posted at 2 p.m.

November 20, 2014

Feedback Sought on Hospital Payment Overhaul Proposal

The chairman of House Ways and Means health panel on Wednesday weighed in on ongoing anxiety over Medicare billing policies for short hospital stays with a draft bill seeking to fix Medicare hospital payment policies. Texas Republican Rep. Kevin Brady is seeking input on a draft measure that revises the Medicare payment process for hospitals, crafts a new rate for short hospital stays and adjusts hospital stay definitions and the payment appeals process.

Confusion over the definition of short inpatient stays has complicated hospital Medicare payments and confused patients.  Medicare auditors have targeted single-day stays in an effort to stamp out improper billing practices but the payment rejections have caused an enormous backlog in the federal payment claim denial appeals process. Comments and suggestions on the new draft House measure may be incorporated into a new bill after the start of the 114th Congress in January.

By Paul Jenks Posted at 8:34 a.m.

October 21, 2014

DEA Clarifies Drug Wastage Disposal Rules

The Drug Enforcement Administration last month issued final regulations on the disposal of strictly controlled substances, such as prescription painkillers. The regulatory effort hopes to improve and expand on methods of disposing highly regulated substance and adjusts stringent record keeping requirements. The complex rules and record keeping requirements also seek to strictly control the custody of controlled substances. However, hospital groups complained that the new rules were unclear on accounting for unused portions — or drug wastage — from medicine administered to patients and is left over in syringes and IV solutions.

The DEA, in a memo released on Friday, clarified that the regulations do not consider any remaining leftover products used for patients in the hospital as part of the hospital’s drug inventory and subject to provisions of the new regulations.  The rules were designed to assist in collecting unused drugs in patients’ home medicine cabinets but the DEA did not intend for the disposal regulations to apply to hospital drug wastage.  However, the agency does urge hospitals to be careful and document the destruction of the drugs.

September 25, 2014

HHS Reports a Decline in Uncompensated Hospital Care

An objective of the health care overhaul’s provisions allowing states to expand coverage offered through the Medicaid program is the reduction in the burden on hospitals treating uninsured patients and the resulting hospital write-offs for uncompensated care. Hospitals are now beginning to recoup some the cost of treatment of previously uninsured patients through Medicaid, especially in states that have expanded the qualifications for Medicaid coverage.

The Department of Health and Human Services on Wednesday detailed the savings impact on hospitals, noting $4.2 billion in savings in states that have expanded the Medicaid program and $1.5 billion in states that have avoided an expansion. The federal government will pick up all of the expanded Medicaid program costs through 2016 and phase down to 90 percent of costs in 2020.

CQ HealthBeat’s (@CQHealthTweet) Rebecca Adams reported that the authors of the law expected a decline in charity care and bad debt as consumers gained insurance coverage. That was also one of reasons why Congress included in the health law billions of dollars in cuts in Medicare and Medicaid payments for hospitals that care for a large share of low-income patients. Additionally, the Affordable Care Act added requirements on charitable hospitals to document and justify policies and limit charges for uncompensated care.






September 19, 2014

Commission Examines Short Hospital Stay Payments

Congress needs lots of help in deciphering and analyzing Medicare provider payment policies and created an expert group – the Medicare Payment Advisory Commission – to advise on payment policy changes. A current major topic on Medicare payments relates to how hospitals are paid based upon the length of a hospital stay.

CQ HealthBeat’s (@CQHealthTweet) John Reichard reported this week that the Medicare payment commission is currently examining Medicare payment policy for single-day hospital stays.

Short inpatient stays, particularly for a single day, are one of the biggest money-makers for hospitals. Medicare currently pays hospitals a fixed sum for a particular diagnosis based on a calculation of costs that typically assumes a longer stay. However, Medicare auditors have targeted single-day stays in an effort to stamp out improper billing practices and the majority of Medicare claim denials in 2012 were for one-day stays.

Hospitals have taken steps to cut the risk of having their billings challenged and are increasingly classifying short-stay patients as being under “observational” status, which pays at lower outpatient rates.  However, patients listed in observational status must pay a 20 percent copay for outpatient treatment while they pay a fixed deductible for inpatient care of $1,200.


By Paul Jenks Posted at 12:30 p.m.
Hospitals, Medicare

July 31, 2014

Medicare Payment Quirk Grabs Senate Panel’s Attention

Senators on Wednesday mulled the impact of a restriction in Medicare payment policies that has riled both hospitals and patients. When a Medicare patient stays in a hospital under “observation status” the person does not qualify for certain Medicare coverage in a subsequent stay in a nursing home or rehabilitation facility — and may end up paying more in co-payments and drug costs.

Full story

By Paul Jenks Posted at 10:10 a.m.
Hospitals, Medicare

July 14, 2014

It’s July, So Here’s Another Article on ‘the July Effect’ pronounces that “The July effect is real: new doctors really do make hospitals more dangerous” in an article posted yesterday. As the site points out, the term “is shorthand for the supposed spike in medical mistakes at hospitals during the month of July — right when millions of medical residents start new jobs.”

Other publications have taken a crack at the topic in recent years; perhaps surprisingly, they’re not all from July. They sometimes cluster around a release of a study:

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