The cms gathers data from the program to reward

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The CMS gathers data from the program to reward hospitals with low readmissions rates and penalize those with high readmissions rates. “The data allows CMS and hospitals to tie outcomes to staffing,” says Young. That means you’ll be directly helping your hospital and yourself if you pay careful attention to patient outcomes. Federal Regulation
Has there been any change to the regulation within the past 5 years? Explain. Section 3025 of the Affordable Care Act requires the Secretary of the Department of Health and Human Services (HHS) to establish HRRP and reduce payments to Inpatient Prospective Payment System (IPPS) hospitals for excess readmissions beginning October 1, 2012 CMS uses excess readmission ratios (ERR) to measure performance for each of the six conditions/procedures in the program: Acute Myocardial Infarction (AMI) Chronic Obstructive Pulmonary Disease (COPD) Heart Failure (HF) Pneumonia Coronary Artery Bypass Graft (CABG) Surgery Elective Primary Total Hip Arthroplasty and/or Total Knee Arthroplasty. Federal Regulation continued
In the FY 2014 IPPS final rule, CMS finalized the following policies: Adopted the application of an algorithm to account for planned readmissions to the readmissions measures. Expanded the applicable conditions beginning with the FY 2015 program to include: (1) patients admitted for an acute exacerbation of chronic obstructive pulmonary disease (COPD); and (2) patients admitted for elective total hip arthroplasty (THA) and total knee arthroplasty (TKA). In the FY 2015 IPPS final rule, CMS finalized the following policies Expanded the applicable conditions beginning with the FY 2017 program to include patients admitted for coronary artery bypass graft (CABG) surgery. In the FY 2016 IPPS final rule, CMS finalized the following policies: Adopted an extraordinary circumstance exception (ECE) policy allowing hospitals that experience an extraordinary circumstance (such as a hurricane or flood) to request an exception. Refined the pneumonia readmission measure by expanding the measure cohort to include additional pneumonia diagnoses: (i) patients with aspiration pneumonia; and (ii) sepsis patients coded with pneumonia present on admission (but not including severe sepsis) beginning with the FY 2017 program. Federal Regulation changes
In the FY 2017 IPPS final rule, CMS finalized the following policy: Revised the date for publicly reporting hospitals’ excess readmission ratio on the Hospital Compare website to allow for the posting of data as soon as possible following the review period. In the FY 2018 IPPS final rule, CMS finalized the following policy: Changed the methodology to calculate the payment adjustment factor in accordance with the 21st Century Cures Act to assess penalties based on a hospital’s performance relative to other hospitals treating a similar proportion of Medicare patients who are also eligible for full Medicaid benefits (i.e. dual eligible) beginning with the FY 2019 program.

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