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.

Discharges against medical advice are on the rise

The proportion of Medicare age patients who choose to be discharged from the hospital through an AMA—against medical advice—form is rising.

DC hospital treating Rep. Scalise has ‘extremely low’ safety ratings

House Minority Whip Steve Scalise, R-Louisiana, has been treated at MedStar Washington Hospital Center since he was shot in June. The hospital has a less-than-stellar safety reputation, according to USA Today.

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Hospitals strongly oppose CMS move to make AO reports public

CMS has proposed requiring private accrediting organizations (AOs), like the Joint Commission, to publicly release what have been confidential survey reports of hospitals. Dozens of AOs and the facilities they inspect asked the agency to take that change out of the final Medicare Inpatient Prospective Payment System (IPPS) rule for 2018, arguing the reports shouldn’t be treated like healthcare quality data.

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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.

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.