Stay in the know with Becker's Hospital Review's weekly roundup of the nation's biggest healthcare news. Here's what you need to know this week.
1. 1,800 hospitals see payment bump under value-based purchasing
In FY 2016, more than 1,800 hospitals will receive a positive payment adjustment under the Medicare Hospital Value-Based Purchasing Program, according to recently released data from CMS on more than 3,000 U.S. hospitals. Base operating MS-DRG payments to eligible Inpatient Prospective Payment System hospitals are being reduced by 1.75 percent in FY 2016, up from the 1.5 percent reduction the year prior, to fund an estimated $1.5 billion in incentive payments for the Value-Based Purchasing Program. The highest performing hospitals in FY 2016 will receive a net change in payments of slightly more than 3 percent after the mandatory 1.75 percent reduction, while the worst performing hospitals will not recoup any of the 1.75 percent reduction.
2. Hospitals face payment cuts at outpatient sites under budget deal
Republican congressional leaders and the Obama administration reached a tentative budget deal on Monday that would raise spending $80 billion over the next two years and includes cuts in spending on Medicare. Under the tentative deal, off-campus outpatient facilities that are bought or set up by hospitals after the bill is enacted will not be eligible for reimbursements under the outpatient prospective payment system. Instead, these departments would be eligible for reimbursements from either the physician payment or ambulatory surgical center payment systems. According to the draft bill, existing provider-based outpatient departments will be grandfathered in, easing the revenue cuts for some hospitals.
3. Class-action settlement forces Anthem Blue Cross to refund $8.3M to Calif. consumers
After agreeing to a class-action settlement, one of California's largest health insurers, Anthem Blue Cross, will refund $8.3 million to approximately 50,000 policyholders, according to the San Francisco Business Times. The settlement resolves two lawsuits — one brought by Consumer Watchdog and another filed by law firm Shernoff Bidart Echeverria Bentley — that alleged Anthem "illegally" increased deductibles and other "annual" out-of-pocket costs to individual policyholders in California in 2011. Consumers no longer need to file legal claims, and Anthem will repay those who paid more due to the mid-2011 increases.
4. New York hospital expected to close by end of 2015
The state health department approved Pomona, N.Y.-based Summit Park Hospital and Nursing Care Center's plan to shut down Dec. 31, according to The Journal News. Ed Day, a Rockland County executive, said Summit Park is losing about $800,000 a month, and the facility is a significant contributor to the city's deficit. Summit Park announced in early October it would have to close after a private buyer backed out of a $32 million deal to take it over. The staff has not yet been laid off, though no patients remain in Summit Park's hospital portion of the facility.
5. Utah shuts down nonprofit insurance co-op
A tenth nonprofit insurance cooperative formed under the Affordable Care Act will close, according to The Salt Lake Tribune. Arches Health Plan, Utah's health insurance co-op, has been ordered to stop offering coverage as of Dec. 31. The co-op insures 66,000 Utahns. The Utah Insurance Department put Arches in receivership Oct. 27. The same day, CMS asked for a final decision on Arches' status. Arches was not able to raise enough funds to guarantee its survivability in 2016.
6. Medication errors occur in half of all surgeries
Recent research from Massachusetts General Hospital in Boston found medication errors and adverse drug events occur in half of all surgeries. The MGH study is the first to measure the incidence of medication errors and adverse drug events during the perioperative period. Researchers found of the almost 3,675 medication administrations in the observed operations, 193 adverse events were recorded, including 153 medication errors and 91 adverse drug events. Nearly 80 percent of those events were determined to have been preventable.
7. Police: Nurse assistant at UPMC hospital helped inmate escape
Police say a nursing assistant at UPMC McKeesport (Pa.) hospital helped a patient, who was shackled to a bed and under guard, escape from the facility, according to a Times Leader report. Following his arrest in a domestic dispute, 26-year-old Alexander Erb was hospitalized at UPMC McKeesport on Oct 12. Police say Mr. Erb escaped from the hospital after a nurse assistant gave him a tissue box with a handcuff key hidden inside it. Mr. Erb eluded authorities for more than 16 hours after escaping from the hospital. The nurse who aided him in his escape, Michele Sims, was arraigned Oct. 26 on charges including hindering apprehension.