CMS Rolls Out Bundled Payment Demo

CMS last week announced that doctors, hospitals, and other health care providers can now apply to participate in a new program known as the Bundled Payments for Care Improvement initiative. Made possible by the Affordable Care Act, it will align payments for services delivered across an episode of care, such as heart bypass or hip replacement, rather than paying for services separately. Bundled payments will give doctors and hospitals new incentives to coordinate care, improve the quality of care and save money for Medicare.  Click here for a detailed CMS backgrounder.


Organizations interested in applying to the bundled payments initiative must submit a Letter of Intent no later than September 22, 2011 for Model 1 and November 4, 2011 for Models 2, 3, and 4. For more information about the various models and the initiative itself click here.

Debt-Cutting Supercommittee Likely to Spare Medicare Benefits

It’s a little too early to tell what the new supercommittee, charged with reducing the nation’s debt by another $1.5 trillion, will do by the end of the year; however, committee member Fred Upton (R-MI) says cutting current Medicare benefits is unlikely.  Click here to read the story.  Supercommittee members have until Thanksgiving to vote out a plan.  The full Congress must vote by December 23 or an automatic 2% sequestration will take effect. Medicaid is exempt from the automatic cut.

$137 Million Awarded for Prevention and Public Health Programs

HHS pumped out $137 million in new grants last week (in addition to the previous week’s $47 million) for prevention and public health programs. The grants come primarily from the Affordable Care Act’s Prevention and Public Health Fund, and support CDC and Prevention and Substance Abuse and Mental Health Services Administration programs. $75 million will go to programs that provide screening, prevention and referrals for people at risk for substance abuse; $42 million to strengthen public health immunization programs; $5 million to expand the national network of tobacco quit-lines; $2.6 million for the CDC’s Emerging Infections Program; and $1.5 million to evaluate and prevent ventilator-associated pneumonia.  Click here to see how much each state received.

CoP Requirements to Change

HHS next month plans to publish a proposed rule revising the conditions of participation for hospitals and other providers in the Medicare and Medicaid program to remove requirements that are inconsistent, obsolete or unnecessarily burdensome, according to the agency’s plan for retrospective review of existing rules, issued last week.  Click here to review the 44-page final plan. There are likely to be many, many changes!

CMS Says Most States’ OK to Review Premium Increases

41 states have received approval to review proposed premium increases of 10% or more in the small group and individual health insurance markets beginning Sept. 1, 2011, according to a report last week from CMS. Click here to review the report.  CMS plans to review individual and small group rates in seven states (Alabama, Arizona, Idaho, Louisiana, Missouri, Montana and Wyoming) and small group rates in two states (Pennsylvania and Virginia) until they “strengthen their review processes and authorities.”

Private HIE and VA Link Up for First Time

The health information exchange that connects 16 hospitals in western North Carolina to the Veterans Administration is the first of its kind in the U.S., according to a joint announcement last week.  With MEDSEEK’s eConnect health information exchange technology, the hospitals in the federated model maintain separate HIE systems and pull data from members’ systems to present patient records wherever they are needed.  Click here for details.

ER CT Use Jumps for Appendicitis Cases

Researchers have found that across U.S. emergency departments, the percentage of adult appendicitis patients who were diagnosed using CT rose from just 6 percent in 1996, to 69 percent in 2006.  According to a new study released last week. Among children, that figure went from zero to 60 percent, the researchers report in the Annals of Emergency Medicine. Click here to read more.

JCAHO Issues Alert Regarding Radiation Exposure

The Joint Commission last week issued a sentinal event alert regarding patient exposure to diagnostic imaging.  Click here to review the alert.

NY Task Force Investigates Non-Profit Exec Pay, Including Providers

New York state officials are seeking information about compensation and benefits for executives at not-for-profit organizations, including hospitals.  Click here for more.  Click here to read the governor’s task force letter.

CMS Hosts EP EHR Call; Helping Providers Get Incentive Pay

Are you an Eligible Professional (Doctors of Medicine or Osteopathy, Doctors of Dental Surgery or Dental Medicine, Doctors of Podiatric Medicine, Doctors of Optometry, Chiropractors, Pediatricians, Nurse Practitioners, Certified Nurse Midwives, Physician Assistants (PAs) who practice at an FQHC/RHC led by a PA.)  interested in participating in the Medicare and Medicaid EHR Incentive Program and getting paid?  CMS is hosting a national conference call September 9 to discuss.  Click here to register for the call.  (Note that Hospital-based EPs may not participate; an EP is considered hospital-based if 90% or more of the EPs services are performed in a hospital inpatient or emergency room setting.)

Obesity Rates Soar:  New Data

Obesity rates worldwide rose from about 5% to almost 10% among men and from 8% to 14% among women from 1980 to 2008, according to data published last week in The Lancet. Americans were the most obese and Japanese were the least obese among developed nations, researchers noted. A separate report in The Lancet found that 50% of U.S. residents will be obese by 2030 based on current trends. Click here to read the Washington Post story.