Hospital Management
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Government Moving to More Risk Arrangements Based on Quality
The Center for Medicare & Medicaid Innovation wants 100% of providers in upside/downside by 2025 and is using the Bundled Payments for Care Improvement Advanced model, primary care models, and (increasingly) more mandatory models to get there.
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Larger Claims Increasing, Leading to Higher Premiums
The medical malpractice insurance market is hardening in response to an increase in claims with large payouts. Hospitals and health systems may feel the effects even if their own claims are stable.
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Uptick in Investigations Expected for 2020; Data Volume Growing
Healthcare risk managers can expect a greater focus on internal investigations and audits in 2020, with much of it aimed at heading off government inquiries with potentially large consequences.
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Avoid the Top Mistakes in Handling Medical Malpractice Claims
A medical malpractice claim is never a walk in the park, but there are ways to make the experience worse and ways to make it better. Becoming aware of some of the most common missteps can help risk managers make the best of a difficult situation.
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Part-Time Documentation Eased Among Many Favorable Rule Changes
Proposed rule changes regarding anti-kickback restrictions offer compliance relief to physicians and hospitals. The revisions propose three levels of protected value-based arrangements.
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Stark Anti-Kickback Law Refined for Clarity
The Department of Health and Human Services recently revised federal anti-kickback laws, changes that are seen as primarily good news for risk managers. The revisions clarify issues that were unclear and easing some restrictions that created compliance risks.
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Hospital Creates Harm Collaborative to Improve Communication With Executives
Some patient safety issues are so important that risk managers and other safety leaders need direct access to the C-suite so that concerns can be addressed quickly. Helen DeVos Children’s Hospital in Grand Rapids, MI, devised a harm collaborative that makes that possible. The collaborative meets weekly so that risk managers and other safety or quality professionals can address the executive team about individual patient cases or trends that are concerning.
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Bioengineered Organ Research on the Recently Deceased
The next frontier in transplant medicine includes bioengineered organs, which raise ethical issues but could help alleviate a critical shortage that leaves more than 100,000 people on organ wait lists annually in the United States.
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Bioemergency Research Might Weigh Risk-Benefit Ratio Differently
The risk-benefit ratio can be different when studies are proposed in response to a national bioemergency, such as Ebola outbreaks and epidemics. Researchers may need to tolerate greater risk to subjects, experts say. The bioemergency research tradeoff is that there might be a greater amount of benefit to society.
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Suggestions for Improving Exempt Determinations by IRBs
Federal regulations provide some room for interpretation in how IRBs might handle exempt determinations under the revised Common Rule. Research programs need to revise their own rules about who makes the determination and how these are handled, given the expansion of the exempt status.