Kaiser Health News Analysis: CMS Will Cut Pay to Nearly 1,500 Hospitals in FY 2014 | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

Kaiser Health News Analysis: CMS Will Cut Pay to Nearly 1,500 Hospitals in FY 2014

November 15, 2013
by Mark Hagland
| Reprints
A Kaiser Health News Analysis finds that nearly 1,500 U.S. hospitals will see cuts in FY 2014 because of two programs

According to an article posted online by Kaiser Health News (KHN) on Nov. 14, the Centers for Medicare & Medicaid Services (CMS) will be cutting payments to nearly 1,500 U.S. hospitals in federal fiscal year (FY) 2014, based on hospitals’ performance in the Hospital Value-Based Purchasing and Readmissions Reduction Programs mandated by the Affordable Care Act (ACA), as calculated by staff at KHN.

As the KHN article points out, “The Value-Based Purchasing payments for the 2014 federal fiscal year are determined by how hospitals scored on three sets of measures. The first are 13 ‘measures of timely and effective care’ also known as ‘process measures. These rate how often hospitals adhered to these clinical guidelines,” such as the percentage of heart attack patients given medication to avert blood clots within 30 minutes of arrival at the hospital. The second set of eight measures are taken from patient satisfaction surveys, and focus primarily on such elements as clinician and staff communication with patients, and other aspects of the patient experience. And the third set of measures uses Medicare mortality rates for heart attack, heart failure, and pneumonia.

For this year, the process measures account for 45 percent of a hospital’s score; the patient satisfaction measures account for 30 percent; and the mortality rates, for 25 percent. Hospitals stand to lose or gain up to 1.25 percent of their regular Medicare reimbursement based on those calculations.

In addition, for the readmissions program, CMS calculated an excess readmission rate for patients first presenting with one or more of three conditions: heart failure, heart attack, and pneumonia. Hospitals in FY 2014 face up to a 2-percent payment reduction for what CMS considers avoidable readmissions.

The figure of nearly 1,500 hospitals nationwide derives from calculations made by staff at Kaiser Health News, and has not been publicly confirmed by CMS.

 

Topics

News

NewYork-Presbyterian, Walgreens Partner on Telemedicine Initiative

NewYork-Presbyterian and Walgreens are collaborating to bring expanded access to NewYork-Presbyterian’s healthcare through new telemedicine services, the two organizations announced this week.

ONC Releases Patient Demographic Data Quality Framework

The Office of the National Coordinator for Health IT (ONC) developed a framework to help health systems, large practices, health information exchanges and payers to improve their patient demographic data quality.

AMIA, Pew Urge Congress to Ensure ONC has Funding to Implement Cures Provisions

The Pew Charitable Trusts and the American Medical Informatics Association (AMIA) have sent a letter to congressional appropriators urging them to ensure that ONC has adequate funding to implement certain 21st Century Cures Act provisions.

Former Michigan Governor to Serve as Chair of DRIVE Health

Former Michigan Governor John Engler will serve as chair of the DRIVE Health Initiative, a campaign aimed at accelerating the U.S. health system's transition to value-based care.

NJ Medical Group Launches Statewide HIE, OneHealth New Jersey

The Medical Society of New Jersey (MSNJ) recently launched OneHealth New Jersey, a statewide health information exchange (HIE) that is now live.

Survey: 70% of Providers Using Off-Premises Computing for Some Applications

A survey conducted by KLAS Research found that 70 percent of healthcare organizations have moved at least some applications or IT infrastructure off-premises.