Health care leaders say the Hospital Readmissions Reduction Program has been successful but progress has stalled, suggesting it might be time for the CMS to end the program. The program has been criticized for failing to consider social determinants in assessing readmission penalties, and experts say health care organizations are participating in other value-based initiatives that measure quality.
Specialty access standards used by five state Medicaid agencies did not significantly improve access to specialist physicians, according to a study in JAMA Internal Medicine. By next year, the CMS will require state Medicaid programs to implement time and distance standards for managed care organizations to ensure Medicaid patients have adequate access to specialist physicians.
A report in Annals of Internal Medicine found physician use of an online resource during maintenance of certification exams did not affect the tests' ability to determine physician skill. The study was based on 825 physicians who took the Internal Medicine Certification exam, with some assigned a closed-book test and others an open-book MOC.
A new health care model designed to improve access to care in underserved rural areas expands the role of hospital emergency departments in providing primary care services and connecting patients to community physicians, according to a study in Annals of Emergency Medicine. "Emergency medicine-primary care partnerships can address rural populations' most pressing social and medical needs," said researcher Margaret Greenwood-Ericksen of the University of Michigan.
EHR access helps emergency medical services organizations improve clinical decision-making during high-stakes transitions of care, and allows long-term post-acute care facilities to improve care coordination between providers and prescribers, experts say. Integrating EHR use and adopting health information exchange can also boost care management and collaboration among physicians in specialty care facilities.
A study in the Journal of the American Medical Informatics Association showed that 44.3% of inpatient and outpatient facilities have EHR systems that allow providers to open three or more patient records at a time, while 38.3% allow only one record to be open at a time and 17.4% allow two records to be open. Researchers suggested that hospitals may reduce the risk of documentation errors by limiting the number of patient records that providers can open at once.
The CMS issued a proposed rule that would eliminate payment models that require certain joint replacement and cardiac rehabilitation care to be bundled under Medicare. Dr. Richard Chazal, immediate past president of the American College of Cardiology, said while the cardiac proposal was "far from perfect," some provisions could help improve patient care and reduce costs.
The National Committee for Quality Assurance said it supports a CMS plan to allow virtual group participation in the Quality Payment Program, which means solo practitioners and small physician practices could report Merit-Based Incentive Payment System requirements as a collective entity. The NCQA also said CMS should provide auto-credit in the MIPS Advancing Care Information category to patient-centered medical homes and patient-centered specialty practices to reduce administrative burdens.
The CMS has issued a proposed rule canceling its episode payment models and the cardiac rehabilitation incentive model, which were slated to start on Jan. 1, 2018. The agency also made significant changes to its joint replacement payment model. Cancellation of the program will impact eligible clinicians, including physicians and non-physician practitioners, who were planning to use participation in the EPMs to qualify as participating in Advanced Alternative Payment Models outlined under the Quality Payment Program. "The ACC will continue to work with CMS on opportunities for clinicians to participate meaningfully in Advanced APMs," said ACC President Mary Norine Walsh, MD, FACC. "As we move from volume-based care to value-based care, the path forward is challenging and we must work together to find solutions." ACC Advocacy staff and leaders are reviewing the update now. More information on the impacts to cardiovascular clinicians and next steps will be posted to ACC.org. Read more.
Nominations for spots on ACC's major operating committees and NCDR subcommittees are open until Friday, Sept. 22. ACC members are encouraged to review the open positions and may self-nominate or nominate a colleague on the Committee Nominations Portal. ACC's ongoing governance transformation has allowed for an increase in open committee positions to expand member involvement and provide additional opportunities for members to impact the work of the College. Applicants will be notified of results in January 2018. For questions or additional information, email firstname.lastname@example.org. For NCDR Committees, email email@example.com.
The mode in which the inevitable comes to pass is through effort.
Oliver Wendell Holmes Jr., jurist
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