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In This Issue
CMS Issues 2017 MA And Part D Advance Notice And Draft Call Letter
HIDI HealthStats — Sociodemographic Factors In Risk-Adjusted Readmission Measures
Critical Access Hospitals: Effective and Compliant Use of Non-Physician Practitioners
Thursday, March 10
state and federal health policy developments
Staff Contact: Andrew Wheeler
The Centers for Medicare & Medicaid Services released proposed updates to the Medicare Advantage and Part D programs though the 2017 Advance Notice and Draft Call Letter. CMS is proposing to increase MA payment rates by 1.35 percent. Percent increases can be seen by downloading “Applicable Percentages for CY 2017.” When factoring in risk-coding tendencies, the average change in MA insurers’ revenue is expected to increase by 3.55 percent. MHA has published an issue brief with additional details.
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HIDI Tech Connect
Staff Contact: Mat Reidhead
The February issue of HIDI HealthStats highlights the importance of including sociodemographic factors in risk-adjusted readmission measures.
Data and Measures. Thirty-day risk standardized readmission rates and ratios for any cause are calculated for acute myocardial infarction, congestive heart failure, pneumonia, chronic obstructive pulmonary disease, total hip and/or total knee arthroplasty and hospitalwide readmissions. The readmission rates are based on patients ages 18 and older with any payer using the most recent 36 months of Missouri hospital inpatient discharge data. The results provided in this analysis represent inpatient discharges in Missouri occurring between June 1, 2012, and May 31, 2015. The same exclusion criteria defined by the Centers for Medicare & Medicaid Services are used to the extent possible. These include patient deaths, transfers, same day readmissions, patients who leave against medical advice, obstetric and non-acute patients, and readmissions flagged by the CMS Planned Readmission Algorithm.
Qualifying index admissions for the condition- and procedure-specific measures are identified using the ICD-9-CM-based cohorts defined by CMS. The HWR measure is divided into five clinical subgroups of patients: medical, surgical/gynecological, cardiorespiratory, cardiovascular and neurological. The HWR method fits an individual model for each of the five clinical subgroups and uses a weighted geometric mean to derive overall, hospitalwide risk-adjusted performance metrics.
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This week is National Eating Disorders Awareness Week. It’s estimated that 20 million women and 10 million men are faced with anorexia nervosa, bulimia nervosa and binge-eating disorders.