CMS: About 500,000 clinicians to get PQRS-related penalty | Study: Black surgery patients have higher readmission risk | 20% of patients return to hospital after observational stay
June 22, 2017
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First Focus
CMS: About 500,000 clinicians to get PQRS-related penalty
The CMS said about 500,000 clinicians will get their fee-for-service Medicare payments cut by 2% this year because they did not meet Physician Quality Reporting System requirements in 2015. The report said half of those affected are physicians and for many the impact may be minor.
Medscape (free registration) (6/20) 
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Study: Black surgery patients have higher readmission risk
A study published in Health Affairs found black surgery patients in fee-for-service Medicare were 33% more likely to have a 30-day hospital readmission than white patients. The study found black patients in Medicare Advantage plans had a 64% greater risk of readmission than white patients.
Health Affairs Blog (6/21) 
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20% of patients return to hospital after observational stay
About 20% of Medicare patients who had an observational stay at a hospital ended up returning within 30 days, and 49.7% were admitted for inpatient care, researchers reported in The BMJ. The study analyzed 363,037 initial observation stays from 2006 to 2011 that resulted in discharge.
Connecticut Post (Fairfield County-Bridgeport) (6/20) 
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Unexplained stroke, explained.
Until an underlying cause is determined—and addressed—cryptogenic stroke patients may be at risk for recurrence. We can help you find the answers. Visit our resource page for the latest information on diagnosis, care management, patient education and more.
Practice & Hospital Management
Direct primary care model may not mean better health, analysts say
Direct primary care model may not mean better health, analysts say
(Joe Raedle/Getty Images)
Health care analysts' concerns about the viability of direct primary care models, which allow patients unlimited services for a flat fee, have been renewed following news that Seattle-based practice Qliance, one of the pioneers in this type of care, has closed its public clinics. Some analysts say the model encourages the "worried well" to get unnecessary care without guarantees patients will get evidence-based services that will improve their health, while others argue cost-effective primary care must be developed inside the health insurance context.
National Public Radio/Kaiser Health News (6/20) 
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E-Health Watch
CMS adds more flexibility to HIT mandates in proposed 2018 MACRA rule
Doctors who choose to continue using their legacy EHR systems would be allowed to do so until next year and those who use 2015-certified EHR editions would receive a 10% payment bonus from the CMS, according to the proposed 2018 Medicare Access and CHIP Reauthorization Act rule. The proposed rule "helps credit clinicians for using health IT within a care improvement context, and we see this as a more outcomes-focused approach to measuring health IT use," said Dr. Doug Fridsma, CEO of the American Medical Informatics Association.
Healthcare IT News (6/21) 
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Report: Health care data breach costs amount to $380 per capita
US companies spend an average of $7.35 million to recover from a data breach, up by 4.7% from last year, and lose an average of $4.03 million from data breaches, compared with $3.32 million in 2016, according to a report by the Ponemon Institute. Researchers found that the health care sector had the highest data breach costs at $380 per capita, followed by the financial sector at $336 per capita.
Becker's Hospital Review (6/20) 
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Other News Highlights
Spotlight on Innovation
Developing drugs at the point of care is the next step in precision medicine
Utrecht University professor of pharmaceutical biotechnology Huub Schellekens and his colleagues are testing a new method of producing precision medicines in the pharmacy of a large academic hospital for the treatment of two orphan diseases. If the proof-of-concept study succeeds, it could lead to lower drug prices and greater patient involvement in treatment decisions, Schellekens writes.
STAT (tiered subscription model) (6/19) 
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Costs & Reimbursement
CMS proposed rule aims to ease MIPS requirements
The CMS' proposed 2018 rule for its Quality Payment Program calls for increasing the threshold for participation in the Merit-Based Incentive Payment System, to exclude eligible clinicians or groups with $90,000 or less in Part B Medicare charges or 200 or fewer Part B Medicare beneficiaries. It also adds a hardship exception under the Advancing Care Information performance category and gives clinicians in small practices bonus points in their final score.
Medscape (free registration) (6/20) 
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Spotlight on JACC Journals
ACC News
ACC Participates in NIH Inclusion Across the Lifespan Conference
Karen P. Alexander, MD, FACC, and Timothy F. Feltes, MD, FACC, chairs of ACC's Geriatric Section and Adult Congenital and Pediatric Cardiology Section, respectively, penned a perspective on detailing their recent participation in the NIH-sponsored workshop titled, Inclusion Across the Lifespan. The 21st Century Cures Act mandated that NIH convene a workshop of experts to provide input on appropriate age groups to be included in research studies involving human subjects and acceptable justifications for excluding participants from a range of age groups from human research studies. The Act also required a review of NIH policies on the inclusion of relevant age groups to determine if these should be updated. The workshop brought together researchers, clinicians, biostatisticians and patient and professional organizations. Read the full perspective on
FDA Cites STS/ACC TVT Registry Data to Expand Use of Sapien 3 Artificial Heart Valve
The FDA recently approved expanding the use of Sapien 3 Transcatheter Heart Valve for patients with symptomatic heart disease due to failure of a previously placed bioprosthetic aortic or mitral valve whose risk of death or severe complications from repeat surgery is high or greater. The FDA originally approved the Sapien 3 THV for transcatheter aortic valve replacement as an alternative option to surgical aortic valve replacement for patients with native aortic stenosis whose risk for death or severe complications from surgery is high or greater. In 2016, the FDA approved furthering the expansion to include patients who are at intermediate-surgical risk for death or complications. The Sapien 3 THV is the first THV device approved for replacement of failed bioprosthetic aortic or mitral valves. The FDA evaluated data from the STS/ACC TVT Registry, which collects clinical data on the safety and effectiveness of transcatheter valve replacement procedures performed in a real-world setting. Read more on
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Education ... is a process of living and not a preparation for future living.
John Dewey,
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This news roundup is provided as a timely update to ACC members and partners interested in quality health care topics in the news media. Links to articles are provided for the convenience of the health care professionals who may find them of use in discussions with patients or colleagues. Opinions expressed in ACC Quality First SmartBrief are those of the identified authors and do not necessarily reflect the opinions or policies of the American College of Cardiology. On occasion, media articles may include or imply incorrect information about the ACC and its policies, positions, or relationships. For clarification on ACC positions and policies, we refer you to
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