Hospital Peer Review – May 1, 2020
May 1, 2020
View Issues
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Pandemic Quality Reporting Eased, But Consider Benefits of Sending Data
Hospital quality leaders already strained by the COVID-19 pandemic welcomed the decision to delay reporting deadlines for the Merit-Based Incentive Payment System and not require reporting or use data from the initial pandemic period for Medicare quality reporting and value-based purchasing programs for future payment years. However, there are important issues to consider as hospitals move forward and regroup in the post-pandemic months.
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States Ease Licensing and Credentialing; Use Caution
Many states have lifted some restrictions on clinician licensing in response to the COVID-19 pandemic, allowing hospitals to call on more available professionals to handle the increased patient load. Although the relaxed rules are welcomed in the face of the crisis, peer review and compliance leaders should proceed with some caution.
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Telehealth Requirements Affected, DEA Allows Prescribing Narcotics
CMS is waiving the “eligible originating site” requirement for telehealth services rendered on or after March 6, 2020, and allowing telehealth services provided in all care settings, including a patient’s home.
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Cost Estimator Aims to Improve Patient Satisfaction
Indiana University Health receives 50,000 requests a year for price estimates and can provide cost estimates for every inpatient and outpatient service at each of the system’s 16 hospitals and every outpatient facility. Estimates are given by phone, in person, or online, and 95% of estimates are completed within 24 hours.
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Study: Hospitality More Influential Than Real Quality
As hospital quality leaders struggle to achieve even small improvements in clinical care results and hope that the effort is rewarded in patient surveys, research suggests comfort amenities like private rooms may be more effective. That does not mean hospitals should shift focus from improving quality of care in favor of easier-to-achieve improvements in hospitality. But it might mean the industry focus on measures like the Hospital Consumer Assessment of Healthcare Providers and Systems survey is misguided.
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Something Is Wrong: Good Cardiac Care Can Result in Lower Payments
Evidence showing that hospitals achieving high marks in cardiac care will not be rewarded in value-based care programs is mounting, In fact, such facilities may be penalized. The risk-adjustment models that determine payment under value-based systems do not adequately account for factors like patient mix. The result can be that hospital leaders feel like they are being punished for providing quality care. That may tempt some to game the system.