CMS

skilled nursing facility
Skilled Nursing Facility Reimbursement: Trouble Ahead?

The American Hospital Association (AHA) is urging CMS to implement an alternate Medicare reimbursement model for skilled nursing facilities (SNFs) before a new clinical groupings model is in place. The current model of Resource Utilization Groups (RUGS) has been criticized as incentivizing the overutilization of resources, as well as demanding…

Hospital ER wait times
Top Factors in Decreasing Hospital Readmission Rates

A new study evaluating CMS hospital readmissions programs was published by the University of Michigan (UM) in the August edition of the Journal of the American Medical Association. After CMS launched the Hospital Remission Reduction program in 2012, healthcare providers across the country have attempted to lower their readmission percentages—and…

List of ACOs
CMS to Divulge Patient ACO Status

In the wake of provider criticisms, CMS has updated how physicians will be made aware of which patients will be monitored for the Medicare ACO program. Medicare beneficiaries will now be allowed to list their primary care provider on the Medicare website. If the doctor is part of an ACO,…

top hospitals by payor mix
Top Hospitals by Medicaid and Medicare Payor Mix

According to a survey released by the Medical Group Management Association (MGMA), operating expenses for medical practices increased at nearly the same rate as revenue between 2015 and 2016. Practices with increased revenue primarily attribute this growth to a greater number of non-physician providers (NPP) and key support staff. The…

Community Health Centers
Community Health Centers Show Billions in Medicare Savings

Every year, the Department of Health and Human Services (HHS) celebrates Community Health Centers Week. From August 12-19, the HHS acknowledged the impact that community health centers have on vulnerable and underserved populations by providing quality care regardless of patient ability to pay. Community health centers (CHCs) are community-based, patient-directed…

Epilepsy management
U.S. Epilepsy Rates Continue to Rise

Epilepsy rates are rising in children and adults according to a new report from the CDC. The percentage of the U.S. population diagnosed with epilepsy rose from 0.8% in 2011 to 1.2% in 2015, totaling over 3 million adults and approximately 0.5 million children. Categorized as a spectrum disorder due…

CMS To Test Child HCAHPS

In 2015, CMS will begin exploring how parents and their children’s satisfaction with their care can impact into hospitals’ Medicaid and Children’s Health Insurance Program (CHIP) reimbursements. This is because CMS has begun using Child Hospital Consumer Assessments of Healthcare Providers and Systems (HCAPHS) surveys to track patient satisfaction in…

Top 10 Providers of Hip Replacements

Total hip replacement, also known as hip arthoplasty, is a common orthopedic procedure. While not as common as knee surgeries, it is expected to become even common as the population ages. More than 332,000 total hip replacements are performed in the U.S. each year according to the Center for Disease Control…

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