CMS hopes to pilot a new, hybrid, hospital-wide readmissions measure that would estimate unplanned readmissions by leveraging Medicare claims data and clinical data from within the electronic medical record, according to the fiscal year 2018 IPPS final rule. The pilot is a precursor for a...Read More »
What happens to physicians who did not meet the qualification thresholds for the advanced Alternative Payment Models (APM) track of MACRA’s Quality Payment Program by August 31? They’ll be placed into the Merit-based Incentive Payment System (MIPS) for the 2017 performance year and the...Read More »
The work of a CDI professional can at times seem isolating and unimportant. Does it matter if a query gets answered? When we educate physicians, and tell them what they document matters, are they listening? Then a case comes along and demonstrates not just that the CDI profession does...Read More »
Through data analysis, CMS concluded that the average length of stay of functional quadriplegia cases are similar to those in MS-DRGs 947 and 948. Ultimately, CMS agreed with the commenter and finalized the assignment of code R53.2 to MS-DRGs 947 and 948.Read More »
A May 2017 HealthLeaders Intelligence Report on Value-Based Readiness found that 74% of surveyed providers depend on fee-for-service payments, and the remaining 26% rely on value-based payment. Providers, however, say that mix will change to 48% fee-for-service and 52% value-based...Read More »
The fiscal year (FY) 2018 IPPS final rule, released earlier this month, decreased the number of electronic quality measure (eCQM) and calendar quarters for which hospitals must submit...Read More »
Q:How does the Supplemental Medical Review Contractor (SMRC) determine which reviews to perform? Does SMRC work for CMS or our Medicare Administrative Contractor (MAC)? Read More »
