Quality

The focus of quality improvement in healthcare is to bolster performance and processes related to diagnostic and therapeutic procedures. Leaders in this space also ensure the proper selection of imaging exams and procedures, and monitor the safety of services, among other duties. Reimbursement programs such as the Merit-based Incentive Payment System (MIPS) utilize financial incentives to improve quality. This also includes setting and maintaining care quality initiatives, such as the requirements set by the Joint Commission.

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How ‘Grey’s Anatomy’ may give patients the wrong ideas about hospital care

It may be obvious to those working in hospitals—and especially in emergency medicine—that a TV medical drama isn’t quite reality. But for patients who are regular viewers of the long-running “Grey’s Anatomy,” the show could have a real-life impact on how satisfied they are with their care.

MIPS reporting requirements could be eliminated

HHS Secretary Alex Azar said he wants to reduce or possibly eliminate reporting requirements for the Merit-based Incentive Payment System (MIPS), instead using claims data and patient surveys so clinicians won’t have to submit any data themselves.

Aetna under investigation after medical director said he never looked at patient records

The California Department of Insurance is now examining Aetna’s claims denial process after a former medical director for the insurer’s Southern California operations, Jay Ken Iinuma, MD, said under oath that he never looked at a patient’s health record when deciding whether to approve a deny a claim.

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Hospitalizations reduced by regional collaboration in Ohio

The establishment of a primary care-led regional health improvement collaboration in the Cleveland area reduced hospitalizations attributed to conditions like heart failure and bacterial pneumonia, saving nearly $40 million, according to a study published in the February 2017 issue of Health Affairs.

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Wasteful healthcare spending totaled $282M in Washington state

In a single year, more than 600,000 patients in Washington state received services that would be considered low value or wasteful, resulting in $282 million in unnecessary healthcare spending.

Healthgrades Names Recipients of 2018 Distinguished Hospital Award for Clinical Excellence

Healthgrades, the leading online resource for comprehensive information about physicians and hospitals, today announced the 250 recipients of the 2018 Distinguished Hospital Award for Clinical Excellence.

CMS investigating ‘patient dumping’ at U of Maryland hospital

A viral video showing a confused patient wearing only a hospital gown being left at a bus stop outside the University of Maryland Medical Center has prompted a CMS investigation into whether the facility violated any federal regulations.

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How nursing homes may be gaming Medicare star ratings

A five-star rating on CMS’s Nursing Home Compare website may not equate to “five-star service,” according to a Florida Atlantic University (FAU) study that found nursing homes’ scores may be artificially inflated.

Around the web

The tirzepatide shortage that first began in 2022 has been resolved. Drug companies distributing compounded versions of the popular drug now have two to three more months to distribute their remaining supply.

The 24 members of the House Task Force on AI—12 reps from each party—have posted a 253-page report detailing their bipartisan vision for encouraging innovation while minimizing risks. 

Merck sent Hansoh Pharma, a Chinese biopharmaceutical company, an upfront payment of $112 million to license a new investigational GLP-1 receptor agonist. There could be many more payments to come if certain milestones are met.