WEEKLY E-BULLETIN


Healthgrades Releases Top Hospital List Based on Clinical Outcomes

Healthgrades last week released its ratings report of top U.S. hospitals based on clinical outcomes. From 2013 through 2015, clinical and quality outcomes varied widely and if all hospitals had performed like those that rated 5 stars, 223,412 lives could have been saved and 162,215 complications may have potentially been avoided, Healthgrades analysis of MedPAR data on Medicare patients concluded. Hospitals that made the top 50 list represent 1% of the total amount of U.S. hospitals, while those that are in the top 100 represent 2%. Click here for the ratings report.  For an interactive Google map identifying all awarded hospitals, click here.  The top 50 hospitals are listed in this news report.

  • A total of 22 states, including Delaware, New Mexico and Hawaii, as well as the District of Columbia did not have any hospitals that received either a 4- or a 5-star rating. The states with the most hospitals in the top 50 list was California with eight hospitals, followed by Illinois and Michigan. According to a new Press Ganey whitepaper, to deliver the highest quality care possible, healthcare leaders and board members must focus on 10 key metrics.  The measures were deemed the most useful to healthcare executives surveyed by Press Ganey. Click here.

 MACRA Details Still Coming to Light

Health policy experts continue to poor over the 2,400 pages of final MACRA regulations released by CMS on October 14.  Among the biggest changes from the proposed rule:  expansion of the low volume exemption; the ‘pick you pace’ options to delay MIPS participation; and the creation of MSSP Track 1+ in 2018.  Click here for our 2-pages of highlights.  There are many, many options for hospitals and physicians to pursue in 2017. Our APM Plus team of specialists are ready to help your hospital and health system make the best choices for 2017.  Click here to learn more.

Cancer Moonshot Initiative Detailed by the White House

The White House last week published its Cancer Moonshot report outlining a series of strategic goals for making 10 years of progress against the disease in half the time. It outlines new government and private sector initiatives to better manage cancer genome data, collaborate on liquid biopsies and make transportation more readily available to cancer patients. Bristol Myers Squibb is committing $25 million over two years to target disparities in cancer care and the Leukemia & Lymphoma Society committed $50 million to target acute myeloid leukemia and announced a new clinical trial, called Beat AML. Click here for the report.

CMS Launches Programs to Improve Clinician Experience with Medicare

CMS has announced a new initiative to improve the clinician experience with the Medicare program.  CMS says the new long-term effort aims to reshape the physician experience by reviewing regulations and policies to minimize administrative tasks and seek other input to improve clinician satisfaction. The initiative will be led by senior physicians within CMS. Click here for details.

BLS: Biggest Rx Drug Price Jump in 24 Years

Americans just experienced the biggest Rx drug price rise in 24 years, according to the latest Bureau of Labor Statistics inflation data. BLS reports that prescription drug prices rose 7.3 percent since last year, the largest one-year hike since July 1992. For comparison, overall inflation was up 1.7 percent year-over-year.  Experts say the price hike is driven by a range of factors – from the introduction of new, expensive drugs to some pharma companies’ ongoing efforts to hike prices – and that barring reforms, higher costs are likely on the way. Click here for the BLS data. Click here for the news report.

Americans with STDs Reaches Record High

According to the latest data from the CDC, the number of Americans with chlamydia, syphilis and gonorrhea reached a record high in 2015 with nearly 2 million reported cases of the sexually transmitted diseases. Nearly 400,000 Americans tested positive for gonorrhea, a 12.8 percent increase over 2014 and about 24,000 contracted syphilis, a jump of 19 percent. Chlamydia remains by far the most common sexually transmitted disease, with more than 1.5 million infections reported last year, an increase of 5.9 percent. The CDC estimates that STDs cost the health care system almost $16 billion annually. Click here for more from the CDC.

Half of Mentally Ill Adults Get No Treatment: Study

More than half of mentally ill U.S. adults get no treatment. Eighty percent of youth with mental-health issues get insufficient or no treatment.  According to a new report, Arkansas, Mississippi and Alabama had the least access to care for the mentally ill and the highest rates of imprisonment, with a total of more than 57,000 incarcerated men and women in those states suffering mental-health conditions. Click here for the Mental Health American analysis.  Click here for the news story.

$2.3 Billion in HIV/AIDS Grants Awarded

HHS has announced nearly $2.3 billion in Ryan White HIV/AIDS Program grants awarded to cities, states, and local community-based organizations in fiscal year 2016. This funding supports a coordinated and comprehensive system of care that provides lifesaving HIV health care, support services, and essential medications to over half a million people living with HIV in the United States.  Click here to see how the funds were distributed.

CMS Announces Primary Care Investment Progress

CMS has announced major progress in the Comprehensive Primary Care (CPC) initiative’s second round of shared savings results. CMS reports that nearly all practices (95 percent) have met quality of care requirements. Over 376,000 Medicare beneficiaries were served by 481 practices and more than 2.7 million patients received care by the initiative overall in 2015. During 2015, CPC generated a total of $57.7 million gross savings in Part A and Part B expenditures and four of the seven regions participating in CPC – the states of Arkansas, Colorado, and Oregon, and the Greater Tulsa region in Oklahoma – realized net savings. Click here to read the CMS report.

Senators Warn Against Settlement with Health Insurers

Senate Republican leaders sent a letter warning the Treasury Department that it doesn’t have the authority to use the government’s Judgment Fund to pay for a legal settlement with health insurers who are suing over the Affordable Care Act’s risk corridor payments. The Senators argue that the fund is only supposed to provide payment if another source is not legally available and argue that just because the risk corridor fund doesn’t have the amount of money expected is irrelevant. Click here to read the letter.

SSA Cost-of-Living Increase Could Lead to Higher Medicare Premiums

The Social Security Administration announced last week that a 0.3 percent Cost of Living Adjustment (COLA) increase in 2017 could lead to large premium increases for many Medicare beneficiaries. Medicare trustees projected this past summer that one-third of beneficiaries could see premium increases of up to 22 percent, though it’s not yet clear how much Part B premiums will go up due to the COLA increase. Click here for the Social Security announcement.

13.8 Million Predicted to Sign Up for Exchanges; New Option Offered

HHS expects 13.8 million people to enroll in the health care exchanges nationwide during the upcoming open enrollment season that begins on Nov. 1, just about 1 million more than the 12.7 million who signed up in 2016. Enrollment is expected to dip throughout 2017 because some won’t pay their initial premium and others may drop coverage for a variety of reasons. For more from HHS, click here.

  • When the Affordable Care Act’s health insurance marketplace opens next week, many consumers will have a new option for the law’s fourth open-enrollment period: standardized health plans that cover basic services without a deductible. Click here for details.

 Nursing Homes File Suit Against CMS on Arbitration Rules

The largest nursing home association, the American Health Care Association, has filed suit to block a new CMS rule prohibiting facilities that receive federal funds from requiring residents to enter into arbitration to settle disputes. AHCA and four other plaintiffs filed the lawsuit in a Mississippi federal court on last week, seeking to halt implementation of the rule, arguing that HHS overstepped its legal authority. The regulations, released in September and set to take effect Nov. 28th, will make it significantly easier for nursing home residents and their families to sue when they believe they’ve been mistreated or cheated. Click here to read the lawsuit.

CMS Adds VA Facilities to Hospital Compare

CMS has announced that it will begin to include Veterans’ hospitals performance data to Hospital Compare with the goal of having VA hospitals on the website to allow comparison with other acute care hospitals. The data is now available in searchable spreadsheets only on the Hospital Compare information page. To view the information already available, click here.

Growing Number of APRNs Complete Patients’ End-of-Life Directives

In states that allow it, nurse practitioners can improve seriously ill patients’ access to advance-care planning, according to a new analysis. The study found that nearly 25,000, or about 11 percent, of the Physician Orders for Life-Sustaining Treatment (POLST) forms submitted between 2010 and 2015 in Oregon were completed by an advanced practice registered nurse. The study also found that of the 19 states using the forms, only three do not allow nurse practitioners to fill them out. Click here to read the study.

Just in Time for Halloween!

In hospitals all over America, doctors and medical staffers are convinced that full moons are harbingers of chaos in their emergency rooms and delivery wards. Doctors and nurses say a full-moon night, particularly right before Halloween, triggers a flood of admissions, notably among patients suffering psychotic episodes, sporting strange injuries or going into labor under unusual circumstances.  Click here for the story.