Archive for August, 2017

 

Little Rhyme or Reason to Post-Stroke Care Choices

Despite medical recommendations that stroke patients choose inpatient rehabilitation facilities for their post-acute care, significant numbers of patients continue to seek such care in skilled nursing facilities.

And experts do not understand why.

The choices, according to a new study, are based primarily on recommendations by hospitals and are being made despite a recommendation by the American Heart Association and American Stroke Association that patients turn to inpatient rehab facilities rather than skilled nursing facilities for post-stroke care.  Researchers found no apparent reason for the choices patients make between the two types of facilities.

Learn more about where stroke patients receive their post-discharge care and why they do so in the study Unexplained Variation for Hospitals’ Use of Inpatient Rehabilitation and Skilled Nursing Facilities After an Acute Ischemic Stroke, which can be found here, on the web site of the journal Stroke.

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Improvements Inspired by Readmissions Reduction Program Level Off

After major improvements during the early years of Medicare’s hospital readmissions reduction program, the program is no longer showing significant new gains.

While Medicare readmissions have fallen from 21.5 percent to 17.8 percent since 2007, there has been very little improvement since 2012, suggesting that most of the benefits from the program have already been achieved.

And in FY 2018, Medicare will penalize almost the same number of hospitals it penalized in FY 2017:  approximately 80 percent of the hospitals subject to the program.

In FY 2018, the average penalty will be 0.73 percent of affected hospitals’ Medicare payments.  Forty-eight hospitals will be penalized the maximum of three percent and at least 90 percent of hospitals in Arizona, Connecticut, Florida, Kentucky, Massachusetts, Minnesota, New Jersey, New York, And Virginia will be penalized.

Learn more about how Medicare’s hospital readmissions reduction program is affecting hospitals and hospital readmissions in this Kaiser Health News article.

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Serving High-Risk Patients Leads to VPB Penalties

Practices that served more socially high-risk patients had lower quality and lower costs, and practices that served more medically high-risk patients had lower quality and higher costs. These patterns were associated with fewer bonuses and more penalties for high-risk practices.

So concludes a new study that looked at the results of the first year of the Medicare Physician Value-Based Payment Modifier Program.

The study looked at 899 physician practices serving more than five million Medicare beneficiaries, and it points to the continuing challenge of how best to serve patients who pose greater socio-economic risks than the average patient.

Learn more these findings and how they were reached in the study “Association of Practice-Level Social and Medical Risk With Performance in the Medicare Physician Value-Based Payment Modifier Program,” which can be found here, on the web site of the Journal of the American Medical Association.…

ACA Reduced Disparities in Access to Care

The Affordable Care Act has reduced socioeconomic disparities in access to health care in the U.S.

According to a new study published in the journal Health Affairs,

Health care access for people in lower socioeconomic strata improved in both states that did expand eligibility for Medicaid under the ACA and states that did not. However, gains were larger in expansion states. The absolute gap in insurance coverage between people in households with annual incomes below $25,000 and those in households with incomes above $75,000 fell from 31 percent to 17 percent (a relative reduction of 46 percent) in expansion states and from 36 percent to 28 percent in nonexpansion states (a 23 percent reduction). This serves as evidence that socioeconomic disparities in health care access narrowed significantly under the ACA.

Learn more about how the study was conducted and what it revealed in the article “The Affordable Care Act Reduced Socioeconomic Disparities In Health Care Access,” which can be found here, on the Health Affairs web site.…