Friday, April 22, 2016


Following up on its inpatient hospital payment changes notice, CMS yesterday made announcements about Medicare pricing changes for skilled nursing facilities, rehabilitation hospitals and hospices.  Healthcare Dive summarizes those notices here

HHS Office for Civil Rights announced two substantial HIPAA privacy / security rule violation settlements with health care providers here and here.

Fierce Healthpayer reports on four best practices on value based payment approaches. Kaiser Health News reports on how large employers are paying their employees to travel to other parts of the U.S., e.g., Johns Hopkins, hospital to undergo surgery at bundled or other valued based rates.  This is similar to the center of excellence approach that has been around since the 1980s.  What the FEHBlog found most interesting is that
In addition to cutting the cost of procedures, another chunk of savings to the companies came from avoiding surgeries that probably shouldn’t happen in the first place.
“We’re seeing up to 30 percent — close to 30 percent of cases — who should not be moving forward with the joint replacement,” [Olivia] Ross [from the Pacific Business Group on Health] said.
What typically happens in these cases, she said, is that employees get a recommendation from a local doctor that they should have surgery, only to have physicians at the selected hospitals deem the operation inappropriate.
In some cases that may be because the employee hadn’t first tried less invasive treatments, such as physical therapy, Ross said. Or the employee may need to lose weight first, to make the surgery safer.
Sadly, ABC News reports that the suicide rate in the U.S. is 24% up over the last 15 years.
Sally Curtin, statistician at the NCHS and one of the report’s authors, said that this report may actually underestimate how pervasive suicide attempts are in the U.S. "What we are measuring here is suicide death," Curtin told ABC News. "We do know that the deaths are the tip of the iceberg for the public health issue. There are many more attempts and hospitalizations.” 
Modern Healthcare digs into the story here.
There were nearly 43,000 U.S. suicides in 2014. More than 14,000 of them were middle-aged whites — twice the combined total for all blacks, Hispanics, Asians, Pacific Islanders, American Indians and Alaska Natives.

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