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Care Transitions is a Centers for Medicare & Medicaid Services quality improvement project for Texas' Lower Rio Grande Valley administered through TMF Health Quality Institute. It is a regional, collaborative effort to reduce avoidable hospitalizations by improving patient care transitions. |
| Volume 1, Issue 4 |
February 2009 |
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| Free Webinar |
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| Register now for the February 24, 2009 "Creating an Ideal Transition Home" free Web Conference.
Register through the TMF Web site.
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In the News |
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February Is American Heart Month: Encourage Your Patients to Give Up TobaccoIn recognition of American Heart Month, CMS reminds health care professionals that Medicare provides coverage of cardiovascular screening blood tests and smoking and tobacco-use cessation counseling for eligible Medicare beneficiaries who meet certain criteria. Smoking causes coronary heart disease, the leading cause of death in the United States. Cigarette smokers are two to four times more likely to develop coronary heart disease than nonsmokers.
Stimulus Bill Includes Funds for Medicaid, Health Coverage, ITThe legislation increases federal matching funds for Medicaid by $89.5 billion through December 2010, including a 2.5% increase for Disproportionate Share Hospital allotments, provides COBRA premium assistance for eligible workers who lose their jobs, invests $20 billion in infrastructure and Medicare and Medicaid incentives to encourage doctors and hospitals to use health IT, and expands incentives for banks to purchase hospitals' tax-exempt bonds.
Baptist Health System of San Antonio is one of five sites CMS recently selected for an Acute Care Episode (ACE) demonstration. ACE is a new hospital-based demonstration that will test the use of a bundled payment for both hospital and physician services for a select set of inpatient episodes of care to improve the quality of care delivered through Medicare fee-for-service. The demo project will also pilot in Albuquerque, Denver, Oklahoma City and Tulsa.
Proactive Care Management Saves Lives of SeniorsA large-scale, three-year study shows hospitalization and death rates among chronically ill seniors can be reduced with enrollment in a proactive care management program. Using dynamic electronic tracking and care coordination tools, nurse care managers oversaw patient care for 3,400 seniors. The study--described in the December 2008 Journal of the American Geriatrics Society--has broad implications for managing care of the more than 130 million Americans with chronic illnesses, two-thirds of whom are 65 or older.
CMS recently announced the final five contractors that will process and pay Medicare claims for health care services under the Medicare Fee-for-Service program. The new contracts that will be administered for up to five years will process and pay 36 percent of the national volume of Medicare Part A and Part B claims payments in 14 states, mostly in the South and Midwest. For complete jurisdiction information and assignments of contractors, visit the CMS Medicare Contracting Reform Web page.
The U.S. Department of Health and Human Services Health Resources and Services Administration has made $3.4 million available for 14 new telehealth grants. The Telehealth Network Grant Program (TNPG) will accept applications until March 6, 2009. TNPG demonstrates how telehealth programs and networks can improve access to quality healthcare services in underserved rural and urban communities. This program will provide funding for Federal fiscal years 2009-2011.
The Medicare Payment Advisory Commission (MedPAC), the committee that reports to Congress on Medicare, recommended freezing Medicare payments for skilled nursing facilities (SNFs) and inpatient rehabilitation facilities (IRFs) in 2010. The committee also recommended that hospitals receive a full Medicare payment update for fiscal year 2010 inpatient and outpatient services, based on the rate of change in the market-basket index, concurrent with implementation of a quality incentive program.
Hawaii's Blue Cross-Blue Shield will make the Internet version of the house call available to everyone in the state. The Hawaiian health plan's 700,000 members pay $10 to use the service. The insurer also offers the service to uninsured patients for $45. Health plans pay American Well a license fee per member and a transaction fee of about $2 each time a patient sees a doctor. |
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When computers replace paper, patient mortality rates drop 15% during hospitalization, according to a study of 41 Texas hospitals by Johns Hopkins School of Medicine researchers.
CMS has retired AMI-6, a quality measures it collects under the agency's hospital quality pay-for-reporting program. Although AMI-6 (Acute Myocardial Infarction Patients without Beta-Blocker Contraindications Who Received a Beta-Blocker within 24 Hours after Hospital Arrival) was removed from the Hospital Compare on January 15, data related to this measure will remain in the current downloadable databases that are accessible from the Hospital Compare Web site until March 26, 2009. They will be removed with the next refresh of Hospital Compare. Historical data related to AMI-6 will continue to be accessible in the archived databases available in the "Downloads" section of the "Hospital Compare" page. Additional background information is posted on the "AMI-6 Fact Sheet" also found in the "Downloads" section.
CMS finalized national Medicare coverage policies preventing the program from paying physicians, hospitals and other health care providers for certain serious surgical errors such as wrong surgical or other invasive procedures performed on a patient, surgical or other invasive procedures performed on the wrong body part and surgical or other invasive procedures performed on the wrong patient.
A new study supported by the Agency for Healthcare Research and Quality reveals hospitalized patients report many adverse events, some that are serious and others that are preventable, that are not documented in the medical record. Among 998 study patients, 23 percent mentioned at least 1 adverse event during their interview, but only 11 percent had an adverse event based on medical record review. Thus, the patients revealed twice the number of adverse events as the medical records did.
Potentially preventable medical errors that occur during or after surgery may cost employers nearly $1.5 billion a year, according to new estimates by the Department of Health and Human Services' Agency for Healthcare Research and Quality (AHRQ). The study found that one of every 10 patients who died within 90 days of surgery did so because of a preventable error and that one-third of the deaths occurred after the initial hospital discharge.
The Wall Street Journal recently reported that dirty scrubs can harbor a considerable amount of superbugs. Should hospitals launder scrubs and restrict wear to only in the hospital? Medscape readers comment on this nurse's blog entry. |
| HOME HEALTH |
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The Medicare Payment Advisory Commission (MedPAC), the committee that reports to Congress on Medicare, recommended freezing Medicare payments for home health agencies in 2010. Commissioners said CMS should accelerate a 2.71% coding reduction planned for home health agencies in 2011, which was contained in the 2008 home health prospective payment system final rule.
"Attachment D" to Chapter 8 of the "Outcome and Assessment Information Set (OASIS) Implementation Manual" has been reissued to promote accurate selection and assignment of the patient's diagnosis on the current OASIS (OASIS B1 [1/2008). Attachment D addresses the diagnoses items that pertain to the home health episode (i.e., M0230, M0240 and M0246) and is currently posted in the "Downloads" section of the "OASIS B1 User Manual" Web page on the CMS Web site. |
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PHYSICIANS and CLINICS
E-Prescribing Incentive Program Update
As of January 1, 2009, eligible professional can participate in the Medicare E-prescribing Incentive Program by reporting on which system they've adopted and reporting at least one measure on their Medicare Part B claims. No sign-up or pre-registration is required for participation in the incentive program.
CMS Medicare Learning Network Offers Two New Free Publications
The ABC's of Providing the Initial Preventive Physical Examination Quick Reference Information Chart
This two-sided laminated chart identifies the components and elements of the initial preventive physical examination (also known as the "Welcome to Medicare" Physical Exam or the "Welcome to Medicare" Visit); provides eligibility requirements, procedure codes to use when filing claims, FAQs, and suggestions for preparing patients for the exam; and lists references for additional information.
The Medicare Preventive Services Quick Reference Information Chart
This two-sided laminated chart is a quick reference to Medicare's preventive services.
To order these free publications, visit the Medicare Learning Network Web page, scroll down to "Related Links Inside CMS" and select "MLN Product Ordering Page." | |
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This material was prepared by TMF Health Quality Institute, the Medicare Quality Improvement Organization for Texas, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 9SOW-TX-CT-09-09
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