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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ACA plans likely to exclude top cancer hospitals

Coverage on the Affordable Care Act (ACA) insurance exchanges, where narrow network plans are dominant, is more likely to exclude doctors associated with National Cancer Institute (NCI)-designated cancer centers, according to a new study published in the Journal of Clinical Oncology.

Two-thirds of patients haven’t completed advance directives for end-of-life care

Advance directives, like awarding power of attorney on health care decisions or completing a living will, haven’t been completed by most patients, including those with chronic illnesses, potentially complicating decisions by hospitals and physicians on end-of-life treatment.

CMS: ACA reinsurance, risk adjustment ‘working as intended’

CMS’ internal review of the reinsurance and risk adjustment programs for the Affordable Care Act exchanges found the initiatives were succeeding stabilizing risk on the marketplace, going against claims of ACA opponents that the market has entered a “death spiral.”

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HFMA 2017: LexisNexis’ Rick Ingraham on using social determinants for ‘proactive patient outreach’

Addressing social determinants of health has been labeled a priority by many studies and healthcare organizations, but that data can also be used by health plans to assess a member’s future risk.

Illinois hospital sued for bird attack on its property

Two years ago, Judy Graves was “viciously” attacked by red-winged blackbirds while walking past Elmhurst Hospital in Elmhurst, Ill. Now she’s suing the hospital for $50,000, claiming it’s liable for her injuries because it didn’t block the walking path or post any warnings about the birds.

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Racial disparity in surgical readmissions greater among Medicare Advantage patients

Black surgical patients in both traditional Medicare and Medicare Advantage (MA) were more likely than white patients to be readmitted to the hospital within 30 days, but for MA beneficiaries, the racial disparity was much greater.

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HFMA 2017: How Yale New Haven Health found ‘improved quality means improved margin’

The shift from volume to value isn’t an easy transition for healthcare, but data can make all the difference, especially for a large system which often takes in complex patients from other facilities, which was the case for Yale New Haven Health System.

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Hospitals improving on bedsore and injury prevention—but progress is ‘too slow’

A new report from the Leapfrog Group and Castlight Health found hospitals rates of pressure ulcers, or bedsores, and patient injuries steadily decreased over the past four years. However, there remained wide variation between hospitals and the majority haven’t met Leapfrog’s prevention standards on both conditions.

Around the web

In the post-COVID era, wages for permanent RNs are rising, and wages for travelers are decreasing. A new report tracked these trends and more. 

Two medical device companies have announced a transaction that could shake up the U.S. electrophysiology market. 

These companies were already part of the Johnson & Johnson family, but they had still retained their previous brand names. Now, each one is officially going by Johnson & Johnson MedTech. 

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