Speaker: Date: Topic
Thomas D. Sills, MD
June 5, 2013
How Healthcare Payment is Changing for Hospitals and Physicians
Responsibility for Content
The take-away points and article links were sent by the Medical Library and the CME Committee.
Diane E. Young, Information Specialist
Take-Away Points of the Lecture
1. Healthcare payments will be based on measurements of quality.
2. Measurements of quality is based on clinical documentation.
3. Coding requires specific documentation.
4. The Hospital Readmissions Reduction Program (HRRP) will penalize hospitals with higher than predicted readmission rates, by cutting their total Medicare reimbursement for FY13 by up to 1%.
Links to Articles Relevant to the Presentation
1. Kreimer S: 12 things hospitalists need to know about billing & coding. Hospitalist 2013;17(1):36-38. http://www.medscape.com/viewarticle/781483
2. Joynt KE & Jha AK: Characteristics of hospitals receiving penalties under the Hospital Readmission Reduction Program. JAMA 2013 Jan 23/30;309(4):342-343. http://jama.jamanetwork.com/article.aspx?articleid=1558273
3. Lee GM et al: Effect of nonpayment for preventable infections in U.S. hospitals. N Engl J Med 2012 Oct 11;367(15):1428-1437. http://www.nejm.org/doi/pdf/10.1056/NEJMsa1202419
4. Hartmann CW et al: The Medicare policy of payment adjustment for health care-associated infections: perspectives on potential unintended consequences. Med Care Res Rev 2012;69:45-61. http://mcr.sagepub.com.ezp-prod1.hul.harvard.edu/content/69/1/45.full.pdf+html
Obtaining the PowerPoint Presentation
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