CMS proposes changes to Hospital Compare rating system | CMS proposes changes to Medicare PFS, QPP rule for 2021 | Top hospitals share ways to reduce health disparities
August 6, 2020
CV Quality SmartBrief
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First Focus
A proposed CMS rule would change how quality ratings on the Hospital Compare website are calculated, replacing latent variable modeling for quality measure group scores with a "simple average of measure scores to calculate measure group scores," the proposed rule states. The proposal also calls for consolidating the measure groups of effectiveness of care, timeliness of care and efficient use of medical imaging into a single Timely and Effective Care measure group.
Full Story: FierceHealthcare (8/5) 
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The CMS unveiled its draft Medicare physician fee schedule and quality payment program rule for 2021, and it includes proposals to expand the list of telehealth services covered by Medicare, simplify billing and coding requirements for office-based and outpatient evaluation and management visits, and increase payment cuts for certain specialty care providers. The agency also proposes changes to the Medicare Shared Savings Program's quality reporting requirements and quality performance standards, raising the Merit-based Incentive Payment System's performance threshold, and postponing implementation of the MIPS value pathways program until 2022.
Full Story: Becker's Hospital CFO Report (8/4),  FierceHealthcare (8/4),  Healthcare Finance (8/4) 
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Hospitals on the US News and World Report 2020-21 Best Hospitals Honor Roll are taking a variety of approaches to reducing health care disparities. Cindy Barnard, vice president of quality at Northwestern Medicine in Chicago, says the focus is on creating robust partnerships with its communities, having a diverse and inclusive workforce, and doing patient-centered quality improvement in areas of clinical vulnerability and disparities.
Full Story: Becker's Hospital Review (8/4) 
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Practice & Hospital Management
The number of physicians affiliated with a health care system increased from 40% to 51% from 2016 to 2018, researchers reported in Health Affairs. Among primary care physicians the increase was from 38% to 49%.
Full Story: Medscape (free registration) (8/5) 
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About 5% of Medicare patients surveyed had received home-based care from 2011 to 2017, and 75% of beneficiaries in that group were homebound, researchers reported in Health Affairs. "The significant unmet needs of this high-need, high-cost population and the known health and cost benefits of home-based medical care should spur stakeholders to expand the availability of this care," the researchers wrote.
Full Story: HealthLeaders Media (8/3) 
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Audie Murphy VA Hospital in San Antonio is receiving transferred patients from community hospitals in the Rio Grande Valley, including Starr County Memorial Hospital, which has only one of its 28 beds available and recently established an ethics committee to prioritize care of people with COVID-19. The VA hospital has around 230 beds in surgical or intensive care wards and can add more, and staff have "spent a lot of time preparing for this pandemic starting in late February, and so we're ready for this," said Valerie Rodriguez-Yu, associate director for patient care services at South Texas Veterans Health Care System.
Full Story: KVUE-TV (Austin, Texas) (7/31) 
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Innovation & Technology Trends
A study published in JAMA Internal Medicine estimated about 38% of older adults in the US were not ready to have video visits with physicians in 2018, mostly because they did not have experience with the technology. About 20% of survey respondents were not ready for video visits due to problems with hearing, communicating or dementia.
Full Story: Physician's Briefing/HealthDay News (8/3) 
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Prevention & Research News
An ACC expert consensus decision pathway published in the Journal of the Amercian College of Cardiology said SGLT2 inhibitors and GLP-1 receptor agonists can be used to reduce risks for major adverse cardiovacular events in patients with type 2 diabetes. "These therapies were initially developed to treat blood glucose in patients with diabetes and now have been shown to have important cardiovascular benefits," said Dr. Brendan Everet, co-chair of the writing committee.
Full Story: Healio (free registration)/Cardiology Today (8/5) 
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A study in the Journal of the American College of Cardiology found most young adults with premature coronary artery disease who had a myocardial infarction did not meet criteria for the use of preventive statin therapy before their attack. Researchers said younger MI survivors also were less likely to be eligible for secondary prevention with nonstatin lipid-lowering treatment, compared with older adults.
Full Story: Medscape (free registration) (8/5) 
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Other News Highlights
Spotlight on JACC Journals
ACC News
The CMS on Aug. 3 released the proposed 2021 Medicare Physician Fee Schedule. Under the proposal, physicians will see a reduced conversion factor from $36.09 to $32.26, effective Jan. 1, 2021. This reduction stems from adjustments made to accommodate new spending resulting from changes to evaluation and management payments in the budget neutral system. CMS estimates that the rule would increase payments to cardiologists by 1% from 2020 to 2021 through updates to work, practice expense and malpractice RVUs, depending on the mix of services provided in a practice. CMS also released the proposed 2021 Hospital Outpatient Prospective Payment System rule, which indicates a 2.6% payment update for hospitals and other proposals. Read more.
The ACC on Aug. 5 released the 2020 Expert Consensus Decision Pathway on Novel Therapies for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes in the Journal of the American College of Cardiology. The document updates the 2018 ACC Expert Consensus Decision Pathway, incorporating practical guidance for cardiologists to initiate and monitor the use of sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists with the goal of reducing cardiovascular risk in patients with type 2 diabetes. Read more.
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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 CV Quality 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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