Hospitals

More documents

Recommendations

Info

Medicare Readmission Reduction Program • Effective FY 2013 • Conditions Measured: • FY2013-2014 Heart Attack, Heart Failure and Pneumonia • FY2015 expand to 4 additional conditions (COPD, CABG, PTCA, Other Vascular) • Reduction applies to all base DRG payment amounts (excludes IME, DSH, outliers) in hospitals with excess readmissions • “Excess” defined as ratio of actual to expected readmissions (risk adjusted) • Reduction is capped at 1%, 2%, and 3% in initial 3 years 2012 AAMC Annual Meeting
Concern with Risk Adjustment • Risk adjustment is critical when comparing outcomes across hospitals to ensure adequate and fair comparisons • Current risk-adjustment methodology for 30-day readmissions adjusts for age, gender and a set of comorbidities for clinical risk (HCCs) • The risk adjustment does not address socio-economic status (SES) • AAMC conducted research to determine if AMCs were disproportionately impacted by the current riskadjustment and evaluate alternate approaches 2012 AAMC Annual Meeting
Page 1 and 2: State of the Academic Clinical Ente
Page 3 and 4: AAMC Health Care Affairs • Suppor
Page 5 and 6: DataTrends: Hospital Margins 2012 A
Page 7 and 8: Hospital Total All-Payer Margins, b
Page 9 and 10: COTH Characteristics Short-Term, Ge
Page 11 and 12: COTH Quarterly Survey Results 2009-
Page 13 and 14: Medicare Resident Limits: Mandated
Page 15 and 16: Resident Limit Redistributions ACA
Page 17 and 18: Sec. 5506 Slots by Teaching Status
Page 19 and 20: Sec. 5506 DGME Slots by State - Fir
Page 21: 2012 AAMC Annual Meeting Readmissio
Page 25 and 26: Readmission Rates are Higher for Du
Page 27 and 28: Approach: Model Specification and S
Page 29 and 30: Readmission Program Impact on COTH
Page 31 and 32: Value-Based Purchasing (VBP) • Mo
Page 33 and 34: How is the VBP Money Moving? Major,
Page 35 and 36: Medicare Spending Per Beneficiary (
Page 37 and 38: Exclusions •IME and DSH payments
Page 39 and 40: MSPB National Distribution 50% Medi
Page 41 and 42: MSPB - Where Spending Occurs Breakd
Page 43 and 44: Physician Payments at HOPD For many
Page 45 and 46: MedPAC Proposal 99213 - Midlevel Es
Page 47 and 48: Study AAMC contracted with The Mora
Page 49 and 50: Distribution of Medicare E/M Visits
Page 51 and 52: Major Teaching Hospitals Serve Prop
Page 53 and 54: High Level Findings • Proposed
Page 55 and 56: What is a bundled payment? • New
Page 57 and 58: AHA-AAMC Bundling Analysis Key Ques
Page 59 and 60: Defining the Bundle Characteristics
Page 61 and 62: Pricing the Bundle Add-on payments
Page 63 and 64: Pricing the Bundle: Add-on Payments
Page 65 and 66: Pricing the Bundle: Patient and Hos
Page 67 and 68: Managing the Bundle: Readmissions s
Page 69 and 70: Managing the Bundle: Percent of Rea
Page 71 and 72: Key Findings • Bundling is here
Page 73 and 74:
Bundled Payments for Care Improveme
Page 75 and 76:
AAMC Applicant Organizations • Al
Page 77 and 78:
Brandeis Data Analysis Total allowe
Page 79 and 80:
BPCI Lessons Learned To Date • AM
Page 81:
Questions??? Additional information
show all

Hospitals

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?