CMS accepting comments through June 27 on proposed MACRA physician payment program
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The Centers for Medicare & Medicaid Services (CMS) is accepting comments through Monday, June 27 at 5:00 p.m. ET on the proposed rule that seeks to implement key provisions of the new quality payment program (QPP) for physicians and other professionals mandated by the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. The AHA strongly encourages you to submit comments to the agency and has provided a model comment letter (click the link to open the Word Document) to assist you.
The AHA supports many of the flexibilities CMS proposes to provide under both the Merit-based Incentive Payment System (MIPS) and advanced alternative payment models (APMs). However, the AHA is urging CMS to change several other proposals. The model comment letter focuses on four issues:
- advanced APMs;
- use of CMS hospital measures in MIPS;
- socioeconomic adjustment; and
- the complexity of the MIPS Advancing Care Improvement performance category.
To learn more about MACRA and its implications for hospitals, visit www.aha.org/MACRA for resources targeting hospital leaders, trustees, physicians and others.
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CDC requests assistance in reporting B. cepacia in pediatric and adult ICU patients
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As part of an ongoing multistate investigation, the Centers for Disease Control and Prevention (CDC) is attempting to identify hospitals that have detected clusters of Burkholderia cepacia (B. cepacia) cases among pediatric or adult ICU patients, particularly since January 2016. To report clusters, please contact the CDC Division of Healthcare Quality Promotion Outbreak at [email protected].
Burkholderia cepacia (also called B. cepacia) is the name for a group or „complex” of bacteria that can be found in soil and water. B. cepacia bacteria are often resistant to common antibiotics. B. cepacia poses little medical risk to healthy people. However, people who have certain health problems such as weakened immune systems or chronic lung diseases, particularly cystic fibrosis, are more susceptible to this bacteria. B. cepacia is a known cause of infections in hospitalized patients.
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CMS announces $10 million to help practices move to alternative payment models
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The Centers for Medicare & Medicaid Services (CMS) has announced up to $10 million in grants for organizations to help clinicians improve patient outcomes and lower costs for Medicare, Medicaid and Children’s Health Insurance Program enrollees through the Transforming Clinical Practice Initiative. Recipients of the second round of Support and Alignment Network grants will provide technical assistance to help clinicians and practices participate in alternative payment models. Eligible applicants include health care delivery systems and plans that provide quality improvement support to a large number of clinicians. CMS expects to award up to five grants of $500,000 to $2.5 million through cooperative agreements. Letters of intent to apply are due July 1 and applications July 11. For more information, see the CMS Blog and factsheet.
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AMA issues updated medical ethics code, guidance for ethical practice in telemedicine
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The American Medical Association (AMA) recently adopted the first comprehensive update to its Code of Medical Ethics in more than 50 years, as well as separate ethical guidance for physicians who respond to individual health queries electronically or provide clinical services through telemedicine. The updated ethics code „keeps pace with emerging demands physicians face with new technologies, changing patient expectations and shifting health care priorities,” said AMA President Steven Stack, MD. The telemedicine guidelines, to be published in coming months, include informing patients about the limitations of the relationship and services provided, and encouraging patients to inform their primary care physician about the encounter, among other recommendations.
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MedPAC issues June report to Congress
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The Medicare Payment Advisory Commission (MedPAC) recently released its June report to Congress, which annually looks at issues affecting the Medicare program and health care delivery and services. The report also recommends a prototype design for a unified prospective payment system for skilled nursing facilities, home health agencies, inpatient rehabilitation facilities and long-term care hospitals, as required by the Improving Medicare Post-Acute Care Transformation Act of 2014. The Centers for Medicare & Medicaid Services is expected to use the prototype to develop a Post-Acute Care PPS by 2023. As previously proposed by MedPAC, the prototype would pay for post-acute care services based on a patient’s clinical characteristics rather than the site of service. Also as previously proposed, the report recommends reducing dispensing and supplying fees for Medicare Part B drugs to rates similar to other payers, and giving isolated rural hospitals the option to convert to an outpatient-only model that would be sustainable in a community with declining inpatient volumes. The commission also recommends changes to the Part D program to lower program costs and protect beneficiaries with high costs. In addition, the report presents an analysis of Medicare telehealth services, including use of telehealth in Medicare Advantage, and recommends expanding the use of waivers in Center for Medicare & Medicaid Innovation programs to include a broader range of telehealth services.
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One hospital’s approach to care redesign
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A program at Brigham and Women’s Hospital in Boston is taking a grassroots approach to care redesign, according to an article from NEJM Catalyst. Called the Brigham Care Redesign Incubator and Startup Program (BCRISP), the three-year-old initiative seeks to engage clinicians, capitalize on their knowledge and experience, spur rapid piloting of proposed ideas, and scale and sustain projects that demonstrate results. To date, BCRISP projects have reduced annual medical expenses by an estimated $4.5 million, the article notes, and have led to 165 proposals and the implementation of 25 pilots across three cohorts.
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Medical society makes available free resources on opioid prescribing and management
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To help address the emerging opioid crisis, the Massachusetts Medical Society has made available free a number resources and continuing medical education (CME) activities on pain management and opioid prescribing. Resources include guidelines for the use of opioid therapy and how clinicians can communicate with patients about their prescriptions, as well as a webinar discussing how to incorporate the new opioid prescribing guidelines into practice. Free CME activities include titles such as „Managing Pain Without Overusing Opioids” and „Principles of Palliative Care & Persistent Pain Management.”
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AHRQ-HRET toolkit helps hospitals implement CANDOR process
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The Agency for Healthcare Research and Quality (AHRQ) has released a toolkit prepared by the AHA’s Health Research & Educational Trust affiliate to help hospital leaders and clinicians communicate accurately and openly with patients and families when something goes wrong with their care. The customizable toolkit uses an AHRQ-developed communication and resolution process called Communication and Optimal Resolution, or CANDOR. „Every day in American hospitals, countless doctors, nurses and other caregivers perform miracles for patients,” said AHA President and CEO Rick Pollack. „And while one incident is one too many, sometimes errors occur. This toolkit helps everyone involved – patients, families, clinicians and administrators – discuss what happened, agree on a resolution and make care safer in the long run.”
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How house calls are saving Medicare money
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House calls are suddenly in vogue again as Medicare officials experiment with ways to make care more efficient and to save money, according to an article from Kaiser Health News. Called „Innovations at Home” and run by the Centers for Medicare and Medicaid Innovations, this pilot program has saved Medicare $25 million in its first year, the article reports. At present, 14 practices around the country are participating. Participating physicians receive Medicare’s usual house calls payment, the article says, and can receive bonuses based on lowering costs and meeting at least three of six performance goals, such as reducing emergency room visits and readmissions and monitoring asthma and high blood pressure.
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CDC to host webinar on antibiotic prescribing in U.S. outpatient settings
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In May, the Centers for Disease Control and Prevention (CDC), in collaboration with Pew Charitable Trusts and others, released new data showing that at least 30 percent of all prescriptions written in doctors’ offices and emergency rooms are completely unnecessary.
Now that we have this alarming data, how do we improve? Join pediatrician and pediatrics emergency medicine doctor Katherine Fleming-Dutra, MD, medical epidemiologist with CDC’s Office of Antibiotic Stewardship, for a free webinar on Tuesday, June 28 from 1:00-2:00 p.m. ET covering:
- A detailed explanation of the findings published in the May 2016 JAMA article
- What CDC is doing to promote antibiotic stewardship across health care settings
- An update on Get Smart About Antibiotics Week 2016
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Register now: Center for Healthcare Governance fall symposium
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The Center for Healthcare Governance (CHG) presents its fall symposium on leading and governing health care organizations, Sept. 18-20, 2016 at the Hyatt Regency Boston, Boston, MA.
Take advantage of CHG’s new pricing to enable board member participation. REGISTER by July 10 for the greatest savings.
In this timely program, trustees and executive leadership will gain insights into the trends that are transforming the delivery system and learn strategies and tools for navigating an increasingly complex environment. Industry experts will offer analyses of the contextual issues framing the health care environment. Small group interactive sessions will explore the board’s responsibility to oversee critically important issues such as executive compensation, succession planning, credentialing and quality improvement.
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FEATURED RESOURCE
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The State of the Behavioral Health Workforce: A Literature Review
For more resources, visit our website.
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The most popular article from our last issue:
AHA, CDC issue patient education resource on prescription opioids
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