Posts in Category: Centers for Medicare & Medicaid Services, CMS, Hospital Value-Based Purchasing Program, Hospital Value-Based Purchasing Program FY 2014, performance pay, Affordable Care Act,

Registries play a role in MIPS reporting  

​MIPS, the Medicare physician reimbursement program set to begin in 2019, is causing healthcare providers to consider the use of registries, if they haven't already, as part of their workflow practices.

This Merit-Based Incentive Payment System, part of the Quality Payment Program (QPP) created under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), directs clinicians to meaningfully use certified electronic health record (EHR) technology, according to the American College of Cardiology.

One effect of the regulations is the promotion of the use of registries to help clinicians manage the reporting of the EHRs. MIPS allocates five bonus points in its scoring mechanism to clinicians who are using registries. "An eligible clinician can earn bonus points by completing additional measures under the Public Health and Clinical Data Registry Reporting objective, such as reporting to a specialized registry (i.e., the PINNACLE Registry) or using certified EHR technology to complete certain activities in the Improvement Activities category, such as managing referrals and consultations," the American College of Cardiology reports.

It makes good sense to incentivize use of registries, says Raymond R. Russell, III, MD., Ph.D., because they can help physicians and their teams face a challenge to develop systems that help fulfill reporting requirements with minimal burden. "For many cardiologists, an effective, efficient approach to reporting quality measures data is to take advantage of the registries at our disposal," he writes in Cardiovascular Business.

Qualified Clinical Data Registries (QCDRs), allow clinicians to report on specialty-developed measures that are robust and uniquely geared to their area of practice, thus fulfilling CMS reporting requirements while closely tracking the quality of their practices.

"As the cardiovascular community moves forward with the new value-based models for performance evaluation and reimbursement, it will be essential to develop effective tools that support efficient completion of requirements," Russell suggests. "Some tools, such as registries, are proven and available to us now."

LUMEDX, as the leading independent provider of ACC and STS registry software, believes registries are the cornerstone ao cardiovascular data intelligence and the foundation of a true CVIS (Cardiovascular Information Systems). For more information, visit our Registries page: http://www.lumedx.com/registries.aspx.

Cardiac Bundled-Payment Program to Go Forward Despite Change in Administration 

The bundled-payment program for cardiac care will go forward despite the Trump administration and the confirmation of new Health & Human Services Secretary Tom  Price, a critic of the program. July 1 remains the start date for the initiative, according to an HHS official who spoke to Modern Healthcare.

Under the bundled-payment model, hospitals in 98 designated markets can keep the savings they achieve if they spend less than the target price for a 90-day episode of care for bypass and heart attack patients. However, hospitals that exceed the target price must repay Medicare -- and Target prices will be determined retrospectively.

The HHS spokesman confirmed that the start of the initiative will not be slowed by the Trump administration, which previously had moved to delay the effective date for a rule that launched it. Nor does it appear that Price will stand in the way of its implementation.

Last fall, Price criticized bundled payments in a letter to then-President Obama. Price objected to the mandatory nature of the initiative, arguing that the Centers for Medicare & Medicaid had exceeded its authority and upset the balance of power between Congress and the president.

CMS predicts that the program--which also covers knee and hip replacement--will save the federal government as much as $159 million between now and 2021. In 2014, the CMS said, heart attack treatment for 200,000 patients cost Medicare more than $6 billion. 

From one hospital to another, the cost of treating heart attack patients varies by as much as 50 percent. Does your hospital have a plan to meet the target prices for bypass and heart attack patients? LUMEDX's Cardiovascular Performance Program can help. Click here to find out how. 

The Promise of Predictive Analysis 

If hospitals could accurately predict which patients were going to experience complications down the road, they could intervene early with those patients, and perhaps prevent them from having to be rehospitalized. Reducing readmissions is one of the potential benefits of predictive analysis, and it’s a big one.

“We have 750 patients every day. Instead of looking at everybody, if we can look at 20 patients, that would be a great advantage,” said Jose Azar, M.D., of Indiana University Health, in an H&HN article.

Also highlighted in the Hospitals & Health Networks article is Christiana Care Health System, which has been using predictive analytics for about five years. The Wilmington, Delaware, nonprofit health system set up its homegrown analytics system in 2012 with $10 million in grant funding from the Centers for Medicare & Medicaid Innovation Center.

Predictive analytics has helped Christiana Care improve on financial and utilization metrics, but administrators cautioned that predictions are no help if an organization doesn’t have the resources to respond to them. That means everyone – from doctors and care managers to nurses and social workers, and even clerical staff – needs to be ready to intervene based on predictions about patients.

“You need to be able to respond to and receive information in real time,” said Terri Steinberg, M.D., chief health information officer at Christiana Care. “That’s the cost of entry,” Steinberg told H&HN. “Without a robust care-management program, there’s no point” in making predictions.

Complimentary webinar recording available

A recent LUMEDX/Christiana Care webinar is now available as an online download or on CD. "Delivering Clinical and Business Excellence — The Power of Data Transparency: How Christiana Care Leverages Cardiology Data to Improve Care Quality and Contain Costs" can be downloaded by clicking hereIf you prefer to have a CD mailed to you, please click here.

 

Are You Ready for the New Cardiac Bundled-Payment Program? 

Heart hospital across the country are preparing for the new mandatory bundled-payment program for cardiac care. Set to begin this July, the program makes hospitals in certain markets accountable for the quality and cost of care for bypass and heart attack patients until 90 days after discharge.

CMS predicts that the program-which also covers knee and hip replacements-will save the federal government as much as $159 million between now and 2021. In 2014, the CMS said, heart attack treatment for 200,000 patients cost Medicare more than $6 billion. From one hospital to another, the cost of treating heart attack patients varies by as much as 50 percent, according to Modern Healthcare.

The bundled-payment model allows hospitals to keep the savings they achieve if they spend less than a target price for an episode of care. However, hospitals that exceed the target price must repay Medicare. Target prices will be determined retrospectively.

LUMEDX offers a path to meeting or beating those targets. Our Cardiovascular Performance Program helps facilities gather the consolidated CV data they need to see and manage quality and cost of care in real time. The program helps CV service lines analyze their data, identify higher-risk patients and act to ensure they are performing at or better than national targets so they can keep any savings they have realized-and avoid repaying Medicare. 

Inpatient costs are likely to account for most of the cost of the 90-day bundled-payment period, and LUMEDX is uniquely positioned to help providers reduce those expenses. Our Cardiovascular Performance Program can help CV service lines contain costs while improving outcomes by reducing:

  • Door-to-balloon time
  • Door-to-Troponin-testing time
  • PCI and CABG complications
  • PCI and CABG cost-per-case variation

These are just a few of the many ways LUMEDX solutions can help heart hospitals demonstrate best-quality, best-value care delivery-and uncover the solutions to radical improvement. 

How will the bundled-payment program impact your CV service line? Share your thoughts in our comment section, below. 

The Best of Cardio and Health IT News: Week of 3/7/16 

Readmissions, Obamacare, and more

CMS targets hospital readmissions after CABG 

A proposed rule from the Centers for Medicare & Medicaid Services (CMS) would penalize hospitals that perform an index coronary artery bypass graft (CABG) and then have an unexpected 30-day readmission, even if the patient was discharged from a different hospital. "The proposed CABG 30-day readmission measure includes Medicare beneficiaries who are 65 years old or older who at the time of the index admission had been enrolled in a Medicare fee-for-service program for at least 12 months," Cardiovascular Business reports. "CMS intends to add CABG to its readmissions reduction program in 2017."

Most support keeping, building on Obamacare

The Affordable Care Act (Obamacare) continues to have public support, with 36 percent of those surveyed saying it should be expanded, according to the latest Kaiser Health Tracking Poll. That's the position advocated by presidential candidate and former Secretary of State Hillary Clinton. Nearly a quarter of respondents would like to see a single government plan, as advocated by Vermont Sen. Bernie Sanders, while 16 percent would repeal the ACA and not replace it. Repealing the act and replacing it with a Republican alternative was favored by 13% of respondents.

Analysis: U.S. health spending wouldn't be substantially decreased by price transparency

"Menu-izing the costs of care doesn’t turn the average American into a skilled healthcare shopper, but don’t blame the consumer," says Health Exec. "While some 43 percent of U.S. healthcare spending does indeed go into 'shoppable,' non-emergent care—everything from flu shots and blood tests to colonoscopies and electively timed surgeries—only around 7 percent of out-of-pocket spending goes to such services. The result, according to a new analysis from the Health Care Cost Institute, is that the healthcare system as a whole wrings little cost benefit out of the push for price transparency."

Cardiovascular risk increases with heavy alcohol consumption

Drinking alcohol is associated with higher cardiovascular risk immediately after consumption, according to systematic review and meta-analysis. "After 24 hours, there was a lower risk for moderate drinkers," Cardiovascular Business reports. "But the risk increased in heavy drinkers for the following day and week."

Major markets could see mega-regional healthcare systems

Consolidation is a trend expected to continue in the healthcare industry, according to Fierce Healthcare. The trend, with increased leverage and revenues, has led to the creation of super-regional system in several large markets. "In Chicago, consolidation reached a crescendo in 2014 when fully integrated health system Northwestern Memorial HealthCare and Winfield, Illinois' Cadence Health finalized a merger, with Northwestern expanding to include four hospitals under the deal," reported Becker's Hospital Review. Since then, Northwestern has expanded its reach, finalizing a deal with KishHealth in Dekalb, Illinois. The system now boasts six hospitals and more than 4,000 workers.

The Best of Cardio and Healthcare News for the Week of 1/4/16 

Did you have a chance to check out the latest news from the cardiology and healthIT communities? Let us help keep you up to date on the stories you won't want to miss.

2016 may bring slower patient growth, higher wages, more expensive drugs

Late 2015 data support health systems' anticipation that the demand surge from patients newly insured under the Affordable Care Act would fade this year. Economists with the Altarum Institute say spending acceleration from the coverage expansion may have peaked last February. 

FDA clears Biotronik's peripheral stent 

The FDA has cleared Biotronik's Astron Peripheral Self-Expanding Nitinol Stent System, a device for improving luminal diameter in patients with iliac atherosclerotic lesions. The stent system is described as a self-expanding stent loaded on an over-the-wire delivery system. 

Patients increasingly turning to mobile health apps

More than 30 percent of consumers last year said they have at least one health app on their smartphones, and 60 percent are willing to have a video visit with a doctor through a mobile device, according to an online survey of 1,000 U.S. adults. An increased use of telehealth apps is one of the predictions for 2016 from the PwC Health Research Institute.

Diagnostic errors, measuring performance among top healthcare quality issues for New Year

Zeroing in on individual doctor performance, reducing diagnostic errors, standardizing performance measures, and rethinking the patient experience may be among the top agenda items for healthcare quality and safety leaders this year. There could also be a greater focus on individual doctor performance as it relates to value-based payment and quality reporting.

Family satisfaction increases when ICUs relax their visiting hours

A survey published in the American Journal of Critical Care shows patients benefit when families visit throughout the day and night. "These findings support open and patient-centered visitation guidelines in critical care settings," the researchers wrote.
 

The Best of Cardio, Health IT News: Week of 12/14/15 

Telehealth trend continues its upward climb

2015 sees digital health funding top $4.3 million

More than $4.3 million flowed into the digital health market this year, with consumer engagement tools, personal health tools, and tracking categories by themselves making up 23 percent of overall funding. Consumerization in healthcare is also driving mergers or funding deals, according to a report by Rock Health.

Doctor shortages, readmission fines drive up use of remote patient monitoring systems

A new report from Frost & Sullivan predicts that the remote patient monitoring market will grow by 13.2 percent during the next five years. The market growth is thought to be caused in part by fear of readmissions penalties, an anticipated doctor shortage, and an increase of chronic health conditions.

Kaiser betting telehealth is the wave of the future

Kaiser Permanente Ventures has invested $10 million in Vidyo, a visual communications company that integrates hi-def video communications into workflow and patients’ electronic health records. Forbes reports that Vidyo is already used by clinicians at Mercy, American Well, Blue Cross/Blue Shield, United Healthcare, and Philips, among others.

Adequate nursing staff increases survival rates for in-hospital cardiac arrest patients 

A new report finds that assigning fewer patients to each nurse and improving working conditions for those nurses can increase the number of in-hospital cardiac arrest patients who live to return home. Outcomes are better “when nurses have a more reasonable workload and work in good hospital work environments," the report’s authors said in an announcement.

STS issues new CABG guidelines

Physicians who perform coronary artery bypass grafting (CABG) should use arteries from the chest and forearm instead of veins from the leg in certain patients, according to guidelines from the Society of Thoracic Surgeons (STS). The STS members who created the guidelines “found that targeting the left internal thoracic artery during CABG procedures was associated with improved survival, graft patency and freedom from cardiac events compared with saphenous vein grafts,” according to cardiovascularbusiness.com.

 

The Best of Cardio and Healthcare News for the Week of 12/7/15 

Good news, bad news: High cholesterol rates are down, but fewer than half of patients are taking their statins

Did you have a chance to check out the latest news from the cardiology community? Let us help keep you up to date on the stories you won't want to miss.

 

The good news: High total cholesterol rates declining among U.S. adults

Rates of total high cholesterol and low high-density protein (HDL) in U.S. adults decreased between 2011 and 2014, according to the Centers for Disease Control (CDC).  From 2009 to 2010, 13.4 percent of adults had high cholesterol and 21.3 percent had low HDL cholesterol. From 2011 to 2014, those percentages dropped to 12.1 percent and 18.5 percent, respectively.

The bad news: Most patients not making changes to reduce cardio risk

Fewer than half of patients considered candidates for cholesterol-lowering treatments are actually implementing the treatments, which include exercising more, taking statin medication and losing weight. “Cholesterol treatment gaps” are greater among non-white ethnic groups in the United States than they are for Americans who are white.

Mood matters! Patients with negative emotions before interventional procedures have more adverse outcomes    

Adverse effects after angioplasty and interventional radiology procedures are more common in patients who are fearful or distressed prior to the procedures. Patients who went in with negative emotions were more likely than those with positive or neutral emotions to experience prolonged lack of oxygen, low or high blood pressure, post-operative bleeding or an abnormally slow heart rate.

Hospital staff don’t feel prepared for a mass casualty event

Are critical care and emergency room (ER) staff ready to handle the next terrorist or other mass casualty event? Two-thirds of the physicians and nurses surveyed recently said no. They’re concerned about shortages of available surgeons, beds and blood supplies. 

What healthcare leaders must do to improve patient outcomes

Outcomes-based patient care requires a paradigm shift that has yet to occur for many in healthcare management, according to a Harvard Business Review blog post. Successfully adapting to this new business model requires investing time and money over the long haul, plus taking two other key actions, the post says.

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