Both short and long hospital stays for heart failure are associated with increased readmission rates, according to a study in the Journal of the American College of Cardiology. Short stays were linked to higher cardiovascular readmissions rates, but fewer non-cardiovascular readmissions, while longer stays were associated with higher readmission rates of all types and a higher risk of death.
Safety-net and non-safety-net hospitals had similar mortality outcomes for percutaneous coronary intervention procedures, researchers reported in the journal JACC: Cardiovascular Interventions. Rates of bleeding and acute kidney injury also were similar.
The number of accountable care organizations has steadily increased since the model was created through the Affordable Care Act in 2010, so by 2017 more than 10% of Americans were covered under an ACO contract. David Muhlestein of Leavitt Partners said ACOs going forward are focusing on areas such as organizational transformation, downside financial risk, health IT and managing multiple ACO deals.
A review of 899 physician practices who participated in the first year of the Medicare Physician Value-Based Payment Modifier program showed those with more socially high-risk patients had lower quality scores and lower costs. The study in the Journal of the American Medical Association found physician practices with more medically high-risk patients also had lower quality and higher costs.
Boston Medical Center is working with the I-PASS Patient Safety Institute to make the best use of the I-PASS tool, which provides a standardized way to do patient hand-offs to improve safety and prevent errors. I-PASS is integrated into electronic health records systems and can be customized for different care units, so clinicians can do benchmarking between units or make hospital comparisons.
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HIMSS Analytics surveyed 436 physicians, practice leaders, practice IT directors and staff from hospital-owned and free-standing outpatient practices and found that 92% of hospital-owned facilities and almost 70% of freestanding facilities have operational EHR/EMR systems. Nearly 60% of respondents reported no plans to replace their current ambulatory EHR solution within the next two years, compared with 6% who said they intended to buy a new solution, down from 9% last year.
Health care clinicians are using the "design thinking" approach and creating innovative ways to improve hospital function and patient care. Thomas Fisher of the Minnesota Design Center at the University of Minnesota says design thinking is helpful when there are fundamental problems in services because it allows for "creative, multidisciplinary thinking around solving the issue."
Medicare payments to acute-care hospitals will increase about 1.3% in 2018, according to the final fiscal year 2018 Inpatient Prospective Payment System rule released by the CMS. One policy change included in the rule is that readmission penalties will reflect a hospital's performance relative to other hospitals with similar numbers of dual-eligible patients.
Medicare in October will reduce payments to 2,573 hospitals by up to 3% due to high readmission rates. Only 174 hospitals on the list were not penalized last year and more than 1,500 hospitals were exempted from penalties by law.
The cover story in the latest issue of Cardiology: Interventions explores the use and potential benefits of robotics for performing PCI, including comments from Ehtisham Mahmud, MD, FACC, and Ryan Madder, MD, FACC. Learn more about Atrial Fibrillation version 3 (AF v3) Accreditation, offered through ACC Accreditation Services, and how this partnership can help hospitals provide the best possible care for patients. New insights from the NCDR explore the potential implications of the PEGASUS-TIMI 54 trial and the development of a risk model to predict 30-day readmissions in PCI patients. Get the full issue at ACC.org/CardiologyInterventions.
The ACC/American Heart Association Task Force on Performance Measures is accepting public comments on the draft of the 2018 ACC/AHA Cardiac Rehabilitation Performance Measure Set, including any measures that the committee should consider modifying, removing or adding. The final version will be published in ACC's and AHA's journals. Comments are due by Sept. 6. Access the survey here.
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