Question

Discuss the impact that you predict will occur for medical care providers with the increased scrutiny of Medicare patient outcomes by the Centers for Medicare and Medicaid Services (CMS). Focus your discussion on the potential institutional impact of non-reimbursable care having to be administered by providers, such as readmits for infections, or readmits within a certain time limit after discharge for the same diagnosis.

Answer 1

Centers of Medicaid and Medicare services(CMS) and Hospital Quality Alliance(HQA) began their publicity 30_day mortality measures for acute illness..CMS annually calculates the following categories of outcomes measures based on claims and administrative data for public reporting..

30_day risk_standarrdizized readmission measures for illness like acute myocardial infarction,heart failure,pneumonia,hip/knee surgery..on July 30,2008 In the Inpatient prospective payment service(IPPS) fiscal year(fy) 2009 final rule,CMS included to categories of condition selected for the hospital acquired conditions payment provision..final rule for surgical site infection following cardiac implantable electronic Device(CIED) and latrogenic pheumothorax with venous catheterization..in 2015 fiscal year additional HACs...

Hospital Readmission Reduction Program:

the Affordable Care Act authorized medicare to reduce payment to acute care hospitals with excess Readmission that are paid under CMS's...IPPS program focuses on patient who are readmitted for selected high_cost or high volume condition and procedures like heart attack,heart failure,pneumonia,COPD,replacement surgery and coronary artery bypass graft surgery(CABG)

This readmission Reduction Program is for to improve Quality of care and care transmission by incutivizing the Reduction of hospital readmission..payment adjustment non_stratified methhologymecan be CMS measures HRRP by calculating excess Readmission ratios for each programs.. stratified methodology hospital performance in the HRRP relatives with performance of hospitals within the same peer group.. measures with 25 or more eligible discharge and an ERR above the peer group medium can ERR (excess Readmission ratios)enter the payment..