CMS makes changes to MSP regulations
Provisions that bar providers from filing claims against liability insurers for care rendered to beneficiaries are being removed from Medicare Secondary Payer regulations. The Centers for Medicare & Medicaid Services (CMS) had not enforced the provisions since 1990, when the U.S. District Court for the District of Columbia, in a lawsuit filed by the American Hospital Association (AHA), held that they were unenforceable, according to a report in the on-line news service AHA News Now.
The change is described in a final rule published in the July 25 Federal Register. The rule, effective 30 days after publication, will have a 60-day comment period. CMS said in the notice that removing the provisions will clarify the agency’s policy and prevent beneficiaries from bringing lawsuits against hospitals based on outdated regulations.
Hospital credit downgrades said to be on the increase
The nation’s hospitals face an uncertain financial future, according to a recent report on Wall Street’s view of hospitals by the Centers for Medicare & Medicaid Services (CMS). A number of stresses over the past year have resulted in an increase in credit downgrades for not-for-profit hospitals and declining stock prices for investor-owned hospital companies, the report said. For example, it explained, hospitals continue to face rising expenses for professional liability insurance, labor costs such as nursing and health insurance, and supplies.
The report added that access to capital to fund needed investments in facilities, technology and information systems has become more restricted for those financially stressed hospitals, contributing to an increase in hospital acquisitions in the past year.
Commenting on the report, Don May, the American Hospital Association’s vice president of policy, said, "The overall financial health of hospitals is at a fragile point, with one in three hospitals reporting negative total margins and losing money providing patient care. Medicare and Medicaid reimbursements are simply not keeping up with the rising cost of caring."
The report, which updates a similar report issued by CMS in April 2002, can be found at www.cms.gov.
Critical focus areas’ for random JCAHO surveys
The Joint Commission for the Accreditation of Healthcare Organizations (JCAHO) has announced that in 2004 it will revise the performance areas evaluated during random unannounced surveys. Beginning in 2004, the reporting of standards compliance will be organized by "critical focus area" — processes, systems or structures in a health care organization that significantly impact the quality and safety of care, JCAHO said.
The change is part of a series of standards and survey process changes under the organization’s Shared Visions, New Pathways initiative, which is discussed at length in the June 2003 issue of Hospital Access Management. The 2004 fixed performance areas will include staffing, infection control, medication management, and the JCAHO National Patient Safety Goals that are relevant to the organization’s care and services.
The variable performance areas will be based on prioritized critical focus areas specific to each organization. For more information, go to www.jcaho.org.
Computer model offered to aid disaster readiness
A disaster readiness advisory issued by the American Hospital Association (AHA) offers a free computer model hospitals can use to plan clinics for dispensing critical drugs or vaccinations in the event of disease outbreaks or bioterrorism. Hospitals can download the model, which is available at www.aha.org/re/disasterreadiness, from the AHA web site and use it to assess what it would take to operate such a clinic in their community. The advisory also reminds hospitals to work with state and/or local public health agencies and hospital associations to plan responses to such events, including practice drills. The model was developed by researchers at Weill Medical College of Cornell University in New York City with funding from the Department of Health and Human Services’ Agency for Healthcare Research and Quality.
Bedside patient education offered by Most Wired’
Hospitals who made the 100 "Most Wired" list for 2003 are using Internet technologies to improve patient education at the bedside, for customer services such as pre-registration, physician referrals and appointment scheduling, and to feed readings from clinical equipment directly into the medical record. The list, which comes from the 2003 Most Wired Survey and Benchmarking Study conducted in cooperation with McKesson Corp. and the Healthcare Information and Management Systems Society, was announced in the July issue of Hospitals & Health Networks magazine.
Many of the hospitals on the list also are deploying electronic disease surveillance systems, or are offering self-assessments for diabetes, cancer, and other diseases on their web sites. More than 400 health systems, representing 1,128 hospitals, responded to the survey. Much of the bedside education programs are in the pilot stage, the survey found, noting that 12% of the Most Wired hospitals have hospitalwide projects, while another 42% are conducting pilot projects. This compares with 3% of the least wired reporting hospitalwide projects and 1% with pilot projects.
Putting key services on-line
Many hospitals are using a combination of video-on-demand and bedside Internet access to disease-specific web sites and chat rooms to provide educational resources. Other hospitals are more innovative, linking disease-specific information to their care plans. Hospitals are continuing their drive to make key customer services available on the web, the survey found, providing the ability to pre-register for services, query claims, and schedule appointments. In 2000, slightly more than 2% of U.S. hospitals provided the ability to pre-register for services on-line, compared with nearly 32% in 2003. Physician referral remains the most prevalent customer service offered via the Internet.
CMS makes changes to MSP regulations; Hospital credit downgrades said to be on the increase; Critical focus areas for random JCAHO surveys; Bedside patient education offered by Most Wired
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