Tag: clinical

Shared Savings Program ACOs reduced Medicare spending by $1 billion, according to OIG report

According to findings reported by the Department of Health and Human Services Office of Inspector General (OIG), accountable care organizations (ACOs) participating in the Shared Savings Program are learning how to achieve greater cost savings over time. The Medicare Shared Savings Program is one of the largest alternative payment models implemented by CMS to reward […]

When Wounds Won’t Heal, Therapies Spread — To The Tune Of $5 Billion

By Marisa Taylor, Kaiser Health News PHILADELPHIA — Carol Emanuele beat cancer. But for the past two years, she has been fighting her toughest battle yet. She has an open wound on the bottom of her foot that leaves her unable to walk and prone to deadly infection. In an effort to treat her diabetic […]

Six ways to maximize your clinical and operational outcomes

Managed care organizations (MCO) are breaking new ground when it comes to controlling and reducing long-term healthcare costs, changing the way care is delivered in today’s skilled nursing facility (SNF). With the number of managed care beneficiaries increasing every year and continual changes in how care is administered and reimbursed, it’s essential that SNFs understand […]

CMS proposes changes to outpatient knee replacement coverage and three-day waiver rule

Two proposals published by the Centers for Medicare & Medicaid Services (CMS) last week suggest two potential changes affecting Medicare coverage and the three-day rule waiver: Medicare may cover outpatient beneficiary knee replacements; and Accountable care organizations (ACO) may no longer be required to submit documents explaining financial relationships between the organization, skilled nursing affiliates […]

More SNF volunteers needed for CMS PAC data collection study

Patient assessment data elements collected across PAC settings must be standardized, according to requirements mandated by the IMPACT Act. CMS has contracted with the RAND Corporation to develop and implement standardized patient assessment data elements mandated by the IMPACT Act. This effort is taking place over a three-year period from October 2015 through September 2018. […]

“Novel solutions needed” for how clinicians select patients for SNFs, according to investigation

Hospital clinicians’ evaluation and decision-making regarding which patients are discharged to a skilled nursing facility (SNF) “may be characterized as rushed, without a clear system or framework,” according to a clinical investigation published by the Journal of the American Geriatrics Society. Due to increased accountability placed on both settings for the outcomes of individuals who […]

Flu vaccine not as effective for seniors last winter compared to the young

Data show that the flu vaccine did a poor job of protecting older adults, ages 65 and older, from the illness last winter. Results were presented by the Advisory Committee on Immunization Practices—a group of health experts that provide recommendations regarding the use of vaccines in the United States—and showed that the vaccine was only […]

CMS proposes quality program updates to ease clinician burdens

Proposed rule aims to simplify reporting requirements and offer support for doctors and clinicians in 2018 On Tuesday, June 20, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would make changes in the second year of the Quality Payment Program as required by the Medicare Access and CHIP Reauthorization Act of […]