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.

CMS hospital star rating system ripped by Medicare advisors

The hospital star ratings from CMS may not be fair to hospitals with sicker patients and create “unneeded complexity,” according to the Medicare Payment Advisory Commission (MedPAC), which hinted at creating its own quality measures and payment structure.

Preventable, Potentially Fatal Patient Identification Errors Analyzed by ECRI Institute Patient Safety Organization (PSO)

PLYMOUTH MEETING, PA—In its newest analysis of patient safety errors, ECRI Institute PSO today releases a Deep Dive review of reported events involving patient identification. 

Physician integration hasn’t improved care at hospitals

Having more physicians employed by hospitals hasn’t provided benefits for patient care, according to a study published in the Annals of Internal Medicine.

AMA: Insurer consolidation a threat to access, quality, affordability

The American Medical Association has spoken out against the proposed Anthem-Cigna and Aetna-Humana mergers before, but the organization went further in a new analysis on how the consolidation of major insurers could affect competition. 

Fraud, unreported deaths alleged at Long Island VA

The investigation of the Northport Veterans Affairs Medical Center in Northport, New York, started with unsafe conditions in their operating rooms, but may have uncovered more widespread issues of fraud and abuse.

Most Medicare Advantage enrollees don’t switch plans

Nearly four out of five (78 percent) Medicare Advantage (MA) prescription drug plan enrollees didn’t change their plan between 2013 and 2014, which the Kaiser Family Foundation said raises questions about whether seniors have what they need to compare coverage.

Comparing the value of surgery, radiation, monitoring for early prostate cancer

Men with early prostate cancer can safely opt out of treatment without increasing their risk, though more patients will want treatment later on even when it’s unnecessary.

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49 states have reduced hospital readmissions since 2010

Almost every state, along with the District of Columbia, saw a decrease in Medicare 30-day hospital readmission rates between 2010 and 2015, falling by 8 percent nationally.

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.