In this issue: Value-Based Reimbursement: CMS Ups the Ante for Hospitals with Proposed Rulemaking; Summary of North Carolina Senate Bill 33's Medical Malpractice Reform; ICE Targets Large Employers - How to Be Prepared; You Can't Say That! The Dangers of Overbroad Social Media Policies; and Health Information Exchanges: Ready or Not Here They Come!
Excerpt from 'Value-Based Reimbursement...' :
Among the many reforms mandated by the Affordable Care Act (ACA), hospitals will be subject to a Hospital Value-Based Purchasing Program (Hospital VBP Program) applicable to Medicare payments for inpatient stays under the Inpatient Prospective Payment System (IPPS). To that end, the Centers for Medicare & Medicaid Services (CMS) has recently issued a proposed rule implementing this program. 76 Fed. Reg. 2454 (January 13, 2011). This rule represents a natural continuum in the line of quality-based health care initiatives from CMS, including the quality reporting programs for hospital inpatient services, hospital outpatient services, physicians and other related health care professionals, home health agencies, and skilled nursing facilities.
To evaluate a hospital’s quality of care under the Hospital VBP Program, the ACA requires CMS to use measures from the Hospital Inpatient Quality Reporting Program (Hospital IQR Program). The Hospital IQR Program, a voluntary system through which hospitals report data related to certain quality measures which is in turn reflected on the Hospital Compare website, presently includes 27 process-of-care measures. Among these are acute myocardial infarction, heart failure, pneumonia, and surgical care; 15 claims-based measures related to mortality and readmission rates; three structural measures regarding cardiac surgery, stroke care, and nursing care; and the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. CMS proposes to use measures identified by the Secretary of the Department of Health and Human Services, initially touching on the following conditions/topics...
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