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Media, News & Topics on prevention, diagnosis & treatment of cardiovascular disease
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The Hazards of Leaving the Hospital

The Hazards of Leaving the Hospital | Heart and Vascular Health | Scoop.it

After being discharged from the hospital, patients may feel relief—and a false sense of security that they are home free

Instead, studies show, patients are vulnerable to a wide range of adverse health events and complications, and they often end up back in the hospital within weeks. Annually, nearly one-fifth of Medicare patients—about 2.6 million older adults—end up readmitted within 30 days, a problem so costly that the federal health program now penalizes hospitals for any readmission deemed to be preventable for heart attack, pneumonia and heart failure. A New England Journal of Medicine report identified the condition as "post-hospital syndrome" that might derive as much from the physical and emotional stress patients experience in the hospital as from lingering effects of the original illness.

Seth Bilazarian, MD's insight:

This is a real problem and is very complex.  Less than half of readmissions are for the reason (diagnosis) of the original hospitalization.  Family support and patient's willingness to comply with medical treatment are big contributors to readmission.  Massive efforts are underway to improve the readmission problem. We have very little data on what will work but CMS is mandating many changes.

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Hospitals to Congress: Drop Payment Cap Proposal

Hospitals to Congress: Drop Payment Cap Proposal | Heart and Vascular Health | Scoop.it

My comment: Unfortunately this is the way things are going from the Medicare adminstrator CMS.  Fees for important services like Echocardiograms and Nuclear stress tests have been dramatically cut when done in physician offices to rates that cannot be sustained.  Many physicians have merged with hospitals because the EXACT same service billed by the hospital is reimbursed 4 times higher.  (Echocardiogram $1,605 vs. $373)

See Same Doctor Visit, Double the Cost

http://professional.wsj.com/article/SB10000872396390443713704577601113671007448.html?mg=reno64-wsj

So now CMS intends to cut the reimbursement to the outpatient physician level.  Common sense & fairness would lead to a fair payment regardless of where the service is provided but these are the capricious aspects of our reimbursement system.  Physician groups should not be paid so little and hospitals should not be paid so much.

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The nation’s four largest hospital associations and their allies are urging Congress to oppose a cap on payments for outpatient services.

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CMS to cut 2nd cardio test pay by 25%? Why in the world?

CMS to cut 2nd cardio test pay by 25%? Why in the world? | Heart and Vascular Health | Scoop.it

The plan by CMS - the Medicare payer, to reduce  technical fees because the procedures are performed on the same day FOR NO OTHER REASON THAN CONVENIENCE TO THE PATIENT is irresponsible and detrimental to the goal of an expedient cardiac work-up.

I couldn't agree more.

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Seth Bilazarian Vlog: What to do about hospital readmission rates

Seth Bilazarian Vlog: What to do about hospital readmission rates | Heart and Vascular Health | Scoop.it

As the CMS moves to cut reimbursement based on high rates of hospital readmission for MI, heart failure, and pneumonia, how can cardiologists—working with other healthcare providers, patients, and their families—provide optimum care and keep people out of the hospital?

Is preventing readmission the base way to judge quality? Can hospitals control social and home life issues that have a huge impact on admission and readmission

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Medicare Prepayment audits to start Aug. 27 in 7 states

Medicare Prepayment audits to start Aug. 27 in 7 states | Heart and Vascular Health | Scoop.it

Take Home Message - Prepayment review has not been done before by CMS.  Previously this was reported to be for cardiac procedures such as angioplasty and defibrillators.

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The Centers for Medicare & Medicaid Services finally gave the official word on when hospitals should brace themselves for prepayment audits--Aug. 27, the agency quietly announced on its website.

The official launch date of Aug. 27 provides the timeline as to when CMS will target hospitals in states with high volumes of fraud or error-prone providers (Florida, California, Michigan, Texas, New York, Louisiana, Illinois) or many short inpatient stays (Pennsylvania, Ohio, North Carolina, Missouri).

The goal is to cut improper payments before they even happen. Shifting away from the pay-and-chase method, Medicare Recovery Auditors (RAC) will review claims before payment to ensure that providers comply with all Medicare payment rules.

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