Tag Archives: cms

Advocates, hospitals at odds about CMS plan to suppress a patient-safety score

Photo by Pixabay via pexels.

Federal officials intend to give hospitals a break in quality scoring due to pandemic strains, by halting reporting of a measure known as the PSI 90 score. Patient-safety and business groups are fighting this plan, arguing it would erode quality of care.

Journalists may find good stories in looking at this battle over a quality measurement that pits Medicare and hospitals against patient-safety and employer groups.

The American Hospital Association (AHA) and the Federation of American Hospitals supported this proposal, which was one of myriad policy changes included in Medicare’s draft fiscal year 2023 rule on payments for inpatient services. They agree with Medicare officials who said they feared the effects of the pandemic might result in distorted results that might prove unfair to hospitals that served many people at highest risk from COVID-19.

Opposition to PSI 90 proposal

Among the leaders of the opposition to the PSI 90 proposal is nonprofit Leapfrog Group. Founded in 2000 by business organizations, Leapfrog has become a major force in lobbying for greater transparency about the quality and cost of health care.

“Suppressing PSI 90 would be a giant leap backward in patient safety and transparency, literally life-threatening, and an outrageous violation of the trust Americans place in the Medicare program,” wrote Leah Binder, M.A., M.G.A., chief executive officer of Leapfrog Group, in a June 17 comment letter to the Centers for Medicare and Medicaid Services (CMS).

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Is CMS putting older adults at increased risk during the pandemic?

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As states struggle to contain cases and deaths from COVID-19, nursing homes and other senior care facilities remain epicenters of outbreaks and fatalities. Yet a rule proposed last year by the Trump Administration would allow facilities to cut back on infection prevention measures, according to recent reports in The New York Times and USA Today.

It seems counterintuitive, but CMS still supports this yet-to-be-finalized proposal. Currently, facilities must employ infection prevention specialists at least part time; they receive specialized training to ensure safety protocols are followed. The rule change would allow nursing homes to hire consultants, who are only required to “spend sufficient time” at the facility. CMS says this would reduce regulatory burden while still ensuring quality care. Continue reading

Problems found in initial federal data on COVID-19 in nursing homes

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When Seema Verma, Centers for Medicare & Medicaid Services administrator, announced June 4 that she and the Centers for Disease Control and Prevention were unveiling COVID-19 data for all the nation’s nursing homes that get federal payment, I thought, “Wow!”

These days, how states are reporting their nursing home COVID cases is varied and random. So this new “unprecedented” federal dataset, “constitutes the backbone of a national COVID-19 virus surveillance system,” Verma said. Continue reading

More data coming online to track COVID-19 in nursing homes

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CMS has finally posted a database of reported deaths by facility for approximately 30,000 nursing homes. The data is updated weekly and provides confirmation of the awful toll this disease is taking on our most vulnerable population. As of June 1, more than 40,000 residents and workers in long-term care facilities have died from COVID-19. And that number is most certainly an undercount.

Information is still disjointed, in part because some states include group homes in their reports to CMS, and others only provide data for institutional long term care settings. Assisted living facilities are not part of the dataset since they’re not federally regulated. But any way you look at it, the numbers are staggering. Continue reading

Tip sheet offers story ideas when reporting on Medicare Advantage

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Medicare Advantage plans may not be all they’re cracked up to be and often mislead consumers, according to a new MedPage Today story by reporter Cheryl Clark, who also is AHCJ’s new patient safety core topic leader. As Clark puts it, “getting out is a lot harder than getting in.”

Anyone turning 65 has several months on either side of their birthday to choose to enroll in traditional Medicare, the government-run health insurance for older adults and certain people under 65 with disabilities. Medicare includes Parts A (hospitalization), B (physician services) and an optional Part D (prescription drug plan). As of November, Medicare covered nearly 39 million people. Continue reading