Four Habits of High-Value Health Care Organizations

The New England Journal of Medicine recently published an article regarding four habits of effective hospitals. Although the article is geared towards, hospitals, the principles below are applicable to any health care organization. Specification and planning – Base choices, transitions, subgroups, and patient pathway on specific, meaningful criteria. Infrastructure design – Create microsystems to meet the needs [...]

New Review Process for Waiver Programs

The reviewers will be using standardized checklists as part of the new review process. The good news is that these checklists are available for providers and may be printed and used as internal QA.

CMS to Offer Nursing Home Quality of Care Incentive

The Centers for Medicare and Medicaid Services (CMS) announced last week that it will offer cash incentives to improve quality of care at nursing homes. CMS will ask Arizona, Mississippi, New York, and Wisconsin to participate. (Source) Quality of care areas include nurse staffing and the scope and severity of deficiency citations the home has [...]

DADS Alerts: CLASS Clarification, Etc.

The Texas Department and Aging and Disability Services (DADS) notified Community Living Assistance and Support Services (CLASS) providers that Form 8604, the Transition Assistance Services (TAS) Assessment and Authorization, has been replaced by Form 3621-A, CLASS Transition Assistance Services. See the TAS handbook for more information. DADS is offering new forms for programs like Deaf/Blind [...]

CMS Seeks to Improve Outpatient Quality of Care

Last week, the Centers for Medicare & Medicaid Services (CMS) announced a final rule that restates its commitment to implementing Value Based Purchasing incentives, one of which is to improve the quality of care with Medicare in hospital outpatient departments (HOPDs). CMS hopes to give hospitals an incentive to improve care by tying quality of [...]

CMS Announces Electronic Prescribing System

As the stereotype goes, physicians’ handwriting is notoriously illegible. Last week, the Centers for Medicare & Medicaid Services (CMS) announced a new electronic prescribing system designed to eliminate medication errors caused by people misreading handwritten prescriptions. (Source) Kerry Weems, CMS acting administrator said “more than 1.5 million Americans are injured every year by drug errors. [...]

CMS Reports Pay-for-Performance Pilot Success

The Centers for Medicare and Medicaid Services (CMS) announced last week that a pilot pay-for-performance program, which pays doctors based on quality of care, has lowered costs “in some cases” and improved quality of care for patients with congestive heart failure, coronary artery disease, and diabetes. According to CMS, four of the 10 groups participating [...]

CMS Set to Base Medicare Hospital Reimbursements on Quality of Care

Yesterday, the Centers for Medicare and Medicaid Services (CMS) proposed to change the way it pays Medicare reimbursements to hospitals. (Kaiser Network) CMS seeks to reduce payments by a flat rate (2 percent to 5 percent) to create an “incentive payment pool” for hospitals that meet quality of care thresholds. According to CQ HealthBeat, the [...]

Cooperation Key to Nursing Home Quality Improvements

Mary Ousley, past chair of the American Health Care Association, which represents long term care providers, testified before a congressional committee last week about the long term care profession’s experience with the Omnibus Budget Reconciliation Act of 1987 (OBRA ‘87). OBRA ’87 is considered landmark legislation because it established many nursing home oversight rules in [...]

Payment Reforms for Inpatient Hospital Services

In an effort to improve the accuracy of payment under the acute care hospital inpatient prospective payment system and give hospitals incentives to improve quality, the Centers for Medicare and Medicaid Services (CMS) proposed a new rule. From the press release: Medicare’s inpatient rates for operating expenses will increase by 3.3 percent in FY 2008 [...]

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