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Hospital Peer Review

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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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • Global Standards Help Improve Patient Safety and Outcomes

    A Louisiana health system is improving safety and patient outcomes by expanding its use of barcodes and other tracking under the commonly used GS1 standards. The effort also is yielding better inventory management. Along the way, the health system developed a GS1 implementation program that other organizations can use.

  • Targeted Rounds Reduce PICU CAUTIs to Zero

    Children’s Hospital of Philadelphia has achieved a rate of zero catheter-associated urinary tract infections through the use of daily targeted rounds. The hospital has maintained that zero rate for more than one year.

  • Late Career Credentialing Policy Addresses Physicians Age 75 Years and Older

    The following bullet points contain more information about the late career practitioner policy that has been instituted at Sinai Hospital of Baltimore.

  • EEOC Sues Hospital for Mandatory Exams for Employees at Age 70 Years

    A lawsuit filed by the U.S. Equal Employment Opportunity Commission alleges one facility's late career practitioner policy is illegal because it singles out individuals for testing based only on their age, not any suspicion about a decline in cognitive or physical abilities.