Tag Archives: CMS

Advanced Primary Care Initiatives Reduce Hospital Admissions, ED Visits: CMS

Preliminary findings from two advanced primary care initiatives from CMS show decreased hospital admissions and emergency department (ED) visits, CMS officials report. The two large-scale tests of advanced primary care—the Comprehensive Primary Care (CPC) initiative and the Multi-Payer Advanced Primary … finish reading Advanced Primary Care Initiatives Reduce Hospital Admissions, ED Visits: CMS

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CMS Hopes to Entice More ACOs with Proposed Risk, Rewards Models

Attempting to attract more accountable care organizations (ACOs) to participate in the Medicare Shared Savings Program (MSSP) without fearing penalties, CMS has released a set of proposed rules with updated penalties and incentives, plus a third new model to attract … finish reading CMS Hopes to Entice More ACOs with Proposed Risk, Rewards Models

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Focus on Preventable Readmissions Could Save Hospitals Financial Penalties

Reporting of hospital readmission rates should be based exclusively on preventable or potentially preventable readmissions, so that hospitals are not unfairly penalized, according to researchers from the Perelman School of Medicine at the University of Pennsylvania and Vanderbilt University. Preventable … finish reading Focus on Preventable Readmissions Could Save Hospitals Financial Penalties

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CMS Finalizes Medicare Bundled Payments Program for FQHCs

CMS will increase Medicare payments to federally qualified health centers (FQHCs) by as much as 32 percent, replacing the current fee-for-service model with a bundled payment model, according to CMS officials. The new payment system, as outlined in the Affordable … finish reading CMS Finalizes Medicare Bundled Payments Program for FQHCs

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Physician Quality Reporting and E-Prescribing Use Increasing: CMS

Participation in two key CMS programs, the Medicare Physician Quality Reporting System (PQRS) and the Electronic Prescribing Incentive Program (eRx), increased significantly in 2012, according to the 2012 Physician Quality Reporting System and Electronic Prescribing (eRx) Experience Report. These two … finish reading Physician Quality Reporting and E-Prescribing Use Increasing: CMS

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40 Percent of Health Plan’s Star Rating Attributed to Regional Variation

Nearly 40 percent of a health plan’s CMS Five-Star Quality rating can be explained by the quality of the providers in a given county or region, says Joseph Johnson, vice president of L.E.K. Consulting. Here he points out where those … finish reading 40 Percent of Health Plan’s Star Rating Attributed to Regional Variation

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23 States Receive Over $307 Million in Bonuses for Enrolling Children in Health Coverage

Twenty-three states received over $307 million in bonuses for improving access to children’s health coverage and successfully enrolling low income, eligible children in Medicaid, according to CMS officials. The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) authorized the … finish reading 23 States Receive Over $307 Million in Bonuses for Enrolling Children in Health Coverage

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Same-Hospital Readmission Rate Unreliable Predictor for All-Hospital Readmission Rate

Same-hospital readmission rates are an unreliable predictor for all-hospital readmissions rates, but that rate is what CMS penalizes hospitals for, according to research from the University of Michigan (U-M) Health System, presented at the 2013 Clinical Congress of the American … finish reading Same-Hospital Readmission Rate Unreliable Predictor for All-Hospital Readmission Rate

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New CMS Mobile Apps Boost Financial Transparency Between Physicians and Healthcare Users

Two free mobile apps designed to increase financial transparency among physicians and healthcare users are now available from CMS, officials have stated. As part of the government’s Open Payments program, the apps are designed to create greater public transparency about … finish reading New CMS Mobile Apps Boost Financial Transparency Between Physicians and Healthcare Users

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More Than One Quarter Pioneer ACOs to Leave Program: CMS

Seven of 32 provider groups that signed up for the Pioneer Accountable Care Organizations (ACOs) program sponsored by CMS did not produce savings and are switching to the Medicare Shared Saving Program (MSSP), according to the CMS. Two other Pioneer … finish reading More Than One Quarter Pioneer ACOs to Leave Program: CMS

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