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Something Is Wrong: Good Cardiac Care Can Result in Lower Payments
Evidence showing that hospitals achieving high marks in cardiac care will not be rewarded in value-based care programs is mounting, In fact, such facilities may be penalized. The risk-adjustment models that determine payment under value-based systems do not adequately account for factors like patient mix. The result can be that hospital leaders feel like they are being punished for providing quality care. That may tempt some to game the system.
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Study: Hospitality More Influential Than Real Quality
As hospital quality leaders struggle to achieve even small improvements in clinical care results and hope that the effort is rewarded in patient surveys, research suggests comfort amenities like private rooms may be more effective. That does not mean hospitals should shift focus from improving quality of care in favor of easier-to-achieve improvements in hospitality. But it might mean the industry focus on measures like the Hospital Consumer Assessment of Healthcare Providers and Systems survey is misguided.
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Cost Estimator Aims to Improve Patient Satisfaction
Indiana University Health receives 50,000 requests a year for price estimates and can provide cost estimates for every inpatient and outpatient service at each of the system’s 16 hospitals and every outpatient facility. Estimates are given by phone, in person, or online, and 95% of estimates are completed within 24 hours.
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Telehealth Requirements Affected, DEA Allows Prescribing Narcotics
CMS is waiving the “eligible originating site” requirement for telehealth services rendered on or after March 6, 2020, and allowing telehealth services provided in all care settings, including a patient’s home.
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States Ease Licensing and Credentialing; Use Caution
Many states have lifted some restrictions on clinician licensing in response to the COVID-19 pandemic, allowing hospitals to call on more available professionals to handle the increased patient load. Although the relaxed rules are welcomed in the face of the crisis, peer review and compliance leaders should proceed with some caution.
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Pandemic Quality Reporting Eased, But Consider Benefits of Sending Data
Hospital quality leaders already strained by the COVID-19 pandemic welcomed the decision to delay reporting deadlines for the Merit-Based Incentive Payment System and not require reporting or use data from the initial pandemic period for Medicare quality reporting and value-based purchasing programs for future payment years. However, there are important issues to consider as hospitals move forward and regroup in the post-pandemic months.
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Pain Management in the Emergency Department: Opioids and Alternative Pain Management Therapies
Opioid therapy can be an effective form of pain management in the ED for acute painful conditions. The risk of addiction and abuse should be considered in every case. Alternatives to opioid therapy include systemic agents, such as acetaminophen, NSAIDs, lidocaine, alpha agonists, anticonvulsants, ketamine, corticosteroids, and local and regional anesthesia.
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Trauma in Pregnancy: A Comprehensive Overview
The authors provide a concise, comprehensive overview of the unique anatomic and physiologic features of pregnancy, as well as modifications and considerations important for the management of the pregnant trauma patient.
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OSHA Allows ‘Enforcement Discretion’ During COVID-19
Responding to respirator shortages during the outbreak of novel coronavirus, the Occupational Safety and Health Administration has issued a memorandum allowing “enforcement discretion” by compliance officers citing the Respiratory Protection standard (29 CFR § 1910.134).
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CDC Defines ‘Low-Risk’ Occupational Exposures to Coronavirus
The CDC recently issued guidelines allowing healthcare personnel (HCP) to continue working if they incur only “low-risk” exposures to patients with COVID-19. With some reported cases of large numbers of HCP furloughed after exposures, the CDC is moving to preserve the workforce in situations where HCP are exposed to infected patients through minor breaks in protocol or personal protective equipment.