To address the high levels of prescription medicine non-compliance, AHRQ and the National Council on Patient Information and Education have released a newly revised guide to help patients learn more about how to take medicines safely. The booklet, Your Medicine: Be Smart. Be Safe., includes a detachable, wallet-sized card that can help patientskeep track of all medicines they are taking, including vitamins and herbal and other dietary supplements.
Available in English and Spanish, the guide includes questions that patients can ask their doctors about their medications.
Source: AHRQ release
Monday, August 8, 2011
AHRQ Focuses on Patient Safety Organizations
The July issue of the U.S. Department of Health and Human Services (HHS) Agency for Healthcare Research & Quality (AHRQ) Web M&M examines the role of patient safety organizations. The issue on features an interview with William Munier, MD, MBA, who directs AHRQ’s Center for Quality Improvement and Patient Safety and heads the Agency’s oversight of the Patient Safety Organization (PSO) program. The interview describes the support that AHRQ provides to PSOs, the variations in state-level protection, and how the agenda for PSOs has evolved in recent years. The July issue also features a spotlight case on the challenges of managing blood thinner medications. Physicians and nurses can receive free CME, CEU or training certification by taking the Spotlight Quiz.
TJC Posts National Safety Goals Presentation
The Joint Commission has posted a presentation outlining 2011-2012 National Patient Safety Goals. The goals were established in 2002; development and oversight of the safety goals is done by the Patient Safety Advisory Group.
Source: The Joint Commission
Source: The Joint Commission
Thursday, August 4, 2011
ISMP Medication Safety Self-Assessments Due August 31
The Institute for Safe Medicine Practices (ISMP) is requesting data submissions until August 31, 2011 for their self-assessment for hospitals to use to evaluate their medication safety practices.
Additional information about the assessments is here.
Source: The Joint Commission
Additional information about the assessments is here.
Source: The Joint Commission
Wednesday, August 3, 2011
AHRQ Releases Report on Improving Consumer HIT Application Development
A new report funded by the U.S. Department of Health and Human Services (HHS) Agency for Healthcare Research and Quality (AHRQ) offers a range of design methods that may be applicable for use in developing consumer health information technology (IT) applications. Improving Consumer Health IT Application Development: Lessons from Other Industries: Background Report offers an environmental scan of design practices found in successful consumer products and identifies those that could support improved development of consumer health IT applications. The full report provides recommendations of methods that can be incorporated into consumer health IT application design processes.
Source: AHRQ News Release
Source: AHRQ News Release
Monday, August 1, 2011
CMS Releases IRF Quality Reporting Program Rule
The Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare payment policies and rates for more than 1,200 freestanding and hospital-based inpatient rehabilitation facilities (IRFs) in Fiscal Year (FY) 2012. The final rule increases IRF payment rates under the IRF Prospective Payment System (PPS) by 2.2 percent and establishes a new quality reporting system authorized by the Affordable Care Act. CMS projects that total payments under the IRF PPS will increase by $150 million in FY 2012.
“The final rule extends to the Inpatient Rehabilitation Facility payment system a quality reporting program designed to encourage these facilities to adopt practices that will better protect patient safety and prevent hospital-acquired conditions, which is an essential part of providing well-coordinated patient-and-family-centered care,” said CMS Administrator Dr. Donald Berwick.”
Initially, IRFs will submit data on two quality measures, a urinary catheter-associated urinary tract infection measure and a measure for new or worsening pressure ulcers, with a third measure—“30-day Comprehensive All Cause Risk Standardized Readmission”--under development. IRFs that do not submit performance data will see their payments reduced by two percentage points beginning in FY 2014. CMS anticipates adding measures for reporting in the future through rulemaking and establishing a process for making the data available to the public. As with other data on the CMS website, the IRFs would have an opportunity to review the data for accuracy before it becomes public.
The final rule will affect payments to more than 200 freestanding rehabilitation hospitals and more than 1,000 IRF units in acute care hospitals and critical access hospitals, beginning with discharges on or after Oct. 1, 2011. Under the IRF PPS, the Medicare payment to an IRF increases after the IRF’s costs for treating a beneficiary exceed an outlier threshold amount. The threshold is set for FY 2012 at an amount that is projected to maintain outlier payments at three percent of total payments under the IRF PPS.
The final rule also:
• Updates the case-mix group (CMG) relative weights using FY 2010 IRF claims and FY 2009 IRF cost report data;
• Uses the final FY 2011 pre-reclassified and pre-floor hospital wage data to determine the FY 2012 rates;
• Freezes the facility-level adjustment factors for FY 2012 at FY 2011 levels for one additional year while the agency explores ways to improve upon the accuracy and consistency of the current methodology used to calculate the facility-level adjustment factors;
• Allows IRFs to receive temporary adjustments to their FTE intern and resident caps if they take on interns and residents who are unable to complete their training because the IRF that had originally been their assigned training site either closed or ended its resident training program; and
• Allows IRF and inpatient psychiatric facility units to expand in the middle of a cost reporting period, rather than restricting such expansions to the start of a cost reporting period.
“The final rule we are announcing today will help ensure that Medicare beneficiaries who require rehabilitation in an inpatient setting, continue to have access to high quality care that will help them meet their rehabilitation goals during the difficult work of recovery,” said Dr. Berwick.
The final rule went on display on July 29, 2011 at the Office of the Federal Register’s Public Inspection Desk and will be available under “Special Filings” at: http://www.ofr.gov/OFRUpload/OFRData/2011-19516_PI.pdf and http://www.ofr.gov/inspection.aspx?AspxAutoDetectCookieSupport=1
It will appear in the Aug. 5, 2011 Federal Register.
For more information, please see: www.cms.hhs.gov/InpatientRehabFacPPS/.
And the CMS Fact Sheet: https://www.cms.gov/apps/media/press/factsheet.asp?Counter=4033.
Source: CMS News Release
“The final rule extends to the Inpatient Rehabilitation Facility payment system a quality reporting program designed to encourage these facilities to adopt practices that will better protect patient safety and prevent hospital-acquired conditions, which is an essential part of providing well-coordinated patient-and-family-centered care,” said CMS Administrator Dr. Donald Berwick.”
Initially, IRFs will submit data on two quality measures, a urinary catheter-associated urinary tract infection measure and a measure for new or worsening pressure ulcers, with a third measure—“30-day Comprehensive All Cause Risk Standardized Readmission”--under development. IRFs that do not submit performance data will see their payments reduced by two percentage points beginning in FY 2014. CMS anticipates adding measures for reporting in the future through rulemaking and establishing a process for making the data available to the public. As with other data on the CMS website, the IRFs would have an opportunity to review the data for accuracy before it becomes public.
The final rule will affect payments to more than 200 freestanding rehabilitation hospitals and more than 1,000 IRF units in acute care hospitals and critical access hospitals, beginning with discharges on or after Oct. 1, 2011. Under the IRF PPS, the Medicare payment to an IRF increases after the IRF’s costs for treating a beneficiary exceed an outlier threshold amount. The threshold is set for FY 2012 at an amount that is projected to maintain outlier payments at three percent of total payments under the IRF PPS.
The final rule also:
• Updates the case-mix group (CMG) relative weights using FY 2010 IRF claims and FY 2009 IRF cost report data;
• Uses the final FY 2011 pre-reclassified and pre-floor hospital wage data to determine the FY 2012 rates;
• Freezes the facility-level adjustment factors for FY 2012 at FY 2011 levels for one additional year while the agency explores ways to improve upon the accuracy and consistency of the current methodology used to calculate the facility-level adjustment factors;
• Allows IRFs to receive temporary adjustments to their FTE intern and resident caps if they take on interns and residents who are unable to complete their training because the IRF that had originally been their assigned training site either closed or ended its resident training program; and
• Allows IRF and inpatient psychiatric facility units to expand in the middle of a cost reporting period, rather than restricting such expansions to the start of a cost reporting period.
“The final rule we are announcing today will help ensure that Medicare beneficiaries who require rehabilitation in an inpatient setting, continue to have access to high quality care that will help them meet their rehabilitation goals during the difficult work of recovery,” said Dr. Berwick.
The final rule went on display on July 29, 2011 at the Office of the Federal Register’s Public Inspection Desk and will be available under “Special Filings” at: http://www.ofr.gov/OFRUpload/OFRData/2011-19516_PI.pdf and http://www.ofr.gov/inspection.aspx?AspxAutoDetectCookieSupport=1
It will appear in the Aug. 5, 2011 Federal Register.
For more information, please see: www.cms.hhs.gov/InpatientRehabFacPPS/.
And the CMS Fact Sheet: https://www.cms.gov/apps/media/press/factsheet.asp?Counter=4033.
Source: CMS News Release
CMS Releases Final Wage Index Changes for Medicare Hospices
Hospices serving people with Medicare will see a 2.5 percent increase in their Medicare payments for fiscal year (FY) 2012, according to a final regulation released by the Centers for Medicare & Medicaid Services (CMS). Hospices are also called upon to begin reporting on the quality of care received by Medicare patients, as a result of this final regulation.
The estimated hospice payments are the net result of a 3.0 percent increase in the “hospital market basket,” an indicator of industry-related price increases, offset by an estimated 0.5 percent decrease in payments to hospices due to updated wage index data and the third year of CMS’ seven-year phase-out of a wage index budget neutrality adjustment factor (BNAF).
The final rule also implements Affordable Care Act requirements, including a hospice quality reporting program, and clarifies previously adopted policies on hospice face-to-face certifications, said Jonathan Blum, deputy administrator and director of CMS’ Center for Medicare.“These payment and policy changes and additional attention to quality will work to encourage better coordination of hospice benefits and fair payments to Medicare hospice providers.”
The final rule continues the BNAF phase-out, now in its third year. The BNAF was implemented in 1997, when the former Health Care Financing Administration (HCFA), now CMS, moved from an outdated wage index to a more current and accurate method for determining hospice payments. To minimize disruption to services during the transition, a special budget neutrality adjustment was applied. In FY 2010 rulemaking, CMS adopted a schedule to phase out the BNAF over seven years, reducing it by 10 percent in FY 2010, 15 percent in FY 2011, and successive 15 percent reductions from FY 2012 through FY 2016.
The final rule revises how CMS calculates each hospice’s yearly aggregate cap. Federal law requires that CMS impose a limit on the aggregate Medicare payments a hospice provider receives annually. CMS calculates each hospice’s aggregate cap by multiplying the number of patients served by the hospice in a cap year by a cap amount. Medicare payments made to a hospice during the cap year that exceed the hospice’s aggregate cap must be refunded to Medicare.
In this final rule, CMS will:
- Change the way it counts hospice patients for the 2012 cap accounting year and beyond. The final policy for counting the number of Medicare hospice beneficiaries in care for a given cap year calculates the cap based on the number of days of care the patient received in that cap year for each hospice. This rule also finalized that the new counting method be applied to past cap years in certain instances.
- Allow hospice providers who do not want a change in their patient counting method to elect to continue using the current method.
- Allow any hospice physician to perform the face-to-face encounter regardless of whether that same physician recertifies the patient’s terminal illness and composes the recertification narrative.
- Implement a hospice quality reporting program, which includes a timeframe for reporting, as required by section 3004 of the Affordable Care Act. The measures that are being adopted in this final rule for the FY 2014 program are one measure endorsed by the National Quality Forum related to pain management and one structural measure that assesses whether a hospice administers a Quality Assessment and Performance Improvement (QAPI) program that contains at least three indicators related to patient care.
As finalized, hospices will be required to begin collecting quality data in October 2012, and will submit the data in 2013; hospices may also voluntarily begin collecting data on the QAPI measure in October 2011 for submission in 2012. Hospices failing to report quality data in 2013 will have their market basket update reduced by two (2) percentage points in FY 2014.
Information on the final hospice wage index payment and policy changes and other healthcare news can also be found on a new web portal, www.healthcare.gov, made available by the U.S. Department of Health and Human Services. A link to the final rule, which will be published in the Federal Register on August 4, 2011, along with accompanying documents will be available at: http://www.ofr.gov/OFRUpload/OFRData/2011-19488_PI.pdf or http://www.federalregister.gov/inspection.aspx.
Source: CMS News Release
The estimated hospice payments are the net result of a 3.0 percent increase in the “hospital market basket,” an indicator of industry-related price increases, offset by an estimated 0.5 percent decrease in payments to hospices due to updated wage index data and the third year of CMS’ seven-year phase-out of a wage index budget neutrality adjustment factor (BNAF).
The final rule also implements Affordable Care Act requirements, including a hospice quality reporting program, and clarifies previously adopted policies on hospice face-to-face certifications, said Jonathan Blum, deputy administrator and director of CMS’ Center for Medicare.“These payment and policy changes and additional attention to quality will work to encourage better coordination of hospice benefits and fair payments to Medicare hospice providers.”
The final rule continues the BNAF phase-out, now in its third year. The BNAF was implemented in 1997, when the former Health Care Financing Administration (HCFA), now CMS, moved from an outdated wage index to a more current and accurate method for determining hospice payments. To minimize disruption to services during the transition, a special budget neutrality adjustment was applied. In FY 2010 rulemaking, CMS adopted a schedule to phase out the BNAF over seven years, reducing it by 10 percent in FY 2010, 15 percent in FY 2011, and successive 15 percent reductions from FY 2012 through FY 2016.
The final rule revises how CMS calculates each hospice’s yearly aggregate cap. Federal law requires that CMS impose a limit on the aggregate Medicare payments a hospice provider receives annually. CMS calculates each hospice’s aggregate cap by multiplying the number of patients served by the hospice in a cap year by a cap amount. Medicare payments made to a hospice during the cap year that exceed the hospice’s aggregate cap must be refunded to Medicare.
In this final rule, CMS will:
- Change the way it counts hospice patients for the 2012 cap accounting year and beyond. The final policy for counting the number of Medicare hospice beneficiaries in care for a given cap year calculates the cap based on the number of days of care the patient received in that cap year for each hospice. This rule also finalized that the new counting method be applied to past cap years in certain instances.
- Allow hospice providers who do not want a change in their patient counting method to elect to continue using the current method.
- Allow any hospice physician to perform the face-to-face encounter regardless of whether that same physician recertifies the patient’s terminal illness and composes the recertification narrative.
- Implement a hospice quality reporting program, which includes a timeframe for reporting, as required by section 3004 of the Affordable Care Act. The measures that are being adopted in this final rule for the FY 2014 program are one measure endorsed by the National Quality Forum related to pain management and one structural measure that assesses whether a hospice administers a Quality Assessment and Performance Improvement (QAPI) program that contains at least three indicators related to patient care.
As finalized, hospices will be required to begin collecting quality data in October 2012, and will submit the data in 2013; hospices may also voluntarily begin collecting data on the QAPI measure in October 2011 for submission in 2012. Hospices failing to report quality data in 2013 will have their market basket update reduced by two (2) percentage points in FY 2014.
Information on the final hospice wage index payment and policy changes and other healthcare news can also be found on a new web portal, www.healthcare.gov, made available by the U.S. Department of Health and Human Services. A link to the final rule, which will be published in the Federal Register on August 4, 2011, along with accompanying documents will be available at: http://www.ofr.gov/OFRUpload/OFRData/2011-19488_PI.pdf or http://www.federalregister.gov/inspection.aspx.
Source: CMS News Release
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