Users of the Centers for Medicare and Medicaid Services (CMS) website Hospital Compare can now compare the incidence of two infections—Methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile (C.diff.)—in hospitals across the nation. Also for the first time, hospitals can be assessed on their delivery of recommended stroke care and timely and effective care to prevent blood clots. Also new to the site are rates of medically unnecessary deliveries of babies scheduled before 39 weeks gestation.
Readmission Rates Drop to 18 Percent—The Lowest in Years
Readmission rates for the first eight months of 2013 fell to less than 18 percent of Medicare beneficiaries—the lowest rate in years—according to data reported by the federal government early this month. Declines were seen across the nation, with average rates decreasing in 49 of 50 states (only Utah's rates, which were already low, held steady). The decline began last year when CMS began meting out penalties of 1 percent of Medicare payments to hospitals that had higher than anticipated readmission rates. Those penalties rose to 2 percent in 2013, and will rise to 3 percent next year.
Op-Ed: Fears of Doctor Shortage Overblown
In an opinion piece for the New York Times, Scott Gottlieb, M.D., and Ezekiel Emanuel, M.D., question the commonly heard view that the United States will experience a widespread doctor shortage in the coming decade as a result of the aging population and the Affordable Care Act's insurance expansions. They note that several new methods of treating patients—including telehealth, remote monitoring, and more timely interventions—will make care more efficient and suggest that non-physician providers (including nurses, pharmacists, and physician assistants) will enable more efficient, team-based care. "The opportunity exists to deliver more services and care with fewer physicians," they write, "but it’s not a foregone conclusion. Policy changes will be necessary to reach the full potential of team care."
Feds Seek to Use Clinical Data Registries for Improvement
Under the terms of the federal Physician Quality Reporting System, physicians must report quality data to a CMS-designated "qualified clinical directory" to receive incentive payments or, by 2015, to avoid penalties. A new rule issued this month by CMS will allow specialist medical societies to determine which quality measures they will report to this system—a move intended to promote greater participation among specialists and thus tap into the trove of data now being reported by specialists to clinical data registries maintained by their specialty societies. But a recent report by the U.S. Government Accountability Office raises concerns that the new rule may give physicians too much flexibility, hindering the government's ability to use clinical registry data to learn about the efficacy and costs of care.