Top Healthcare Quality Issues for 2014, Part 1

Cheryl Clark, for HealthLeaders Media , January 6, 2014

"This has not yet been put forth as part of the inpatient hospital quality reporting program, so it would not be eligible for value-based performance payment at this point," says Richard Bankowitz MD, chief medical officer for the hospital quality improvement group and purchasing organization, Premier Inc. "However, the interest that CMS has expressed in this through the LEAPT program makes this a condition to watch."

CMS had proposed to add "contrast-induced acute kidney injury" to its list of hospital-acquired conditions for which the agency would not pay for additional required care, but has suspended that effort until implementation of ICD-10.

Look for HA-AKI to start getting reported in some format in coming years.

2. Readmission Penalty To Cut 3%
Adding to hospital concerns about loss of Medicare payments is the readmission penalty, which increases from up to 2% in the 2014 fiscal year, to as much as 3% of a hospital's Medicare DRG starting with discharges for the 2015 fiscal year.

See Also: Targeting All-Cause Readmissions an Ambitious Strategy

In addition to efforts directed at curtailing readmissions of patients initially treated for heart failure, pneumonia, and heart attack, CMS is adding hip and knee arthroplasty (THA and TKA) and chronic obstructive pulmonary disease (COPD) into the formula.

In its final rule, CMS officials pointed to two reasons for inclusion of hip and knee procedures. First, at least 1.4 million procedures were performed on Medicare beneficiaries per year, and because "combined, THA and TKA procedures account for the largest procedural cost in the Medicare budget."

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