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FFY 2025 Medicare Inpatient Prospective Payment System proposed rule

Key IPPS updates you need to know about  On April 10, Centers for Medicare & Medicaid Services (CMS) released the federal fiscal year (FFY)   2025 Medicare Inpatient Prospective Payment System proposed rule . This rule proposes significant changes and updates to Medicare fee-for-service (FFS) payments and policies.  Understanding these changes is crucial for healthcare professionals, state hospital associations and multi-state health systems. This blog aims to break down the key points and implications of this proposed rule to help you stay informed and prepared.  Overview of the proposed rule  The proposed rule includes regular updates to wage indexes and the market basket. Below are some policies being proposed.  1. Data utilization for standard calculations  CMS plans to use FFY 2023 Medicare Provider Analysis and Review (MedPAR) claims data and FFY 2022 Hospital Cost Reporting Information System (HCRIS) data for standard calculations. Using MedPAR and HCRIS data ensures that th

Health Equity Impact Assessment: 3 FAQs on impartial data

Sourcing impartial data is an essential step in conducting a Health Equity Impact Assessment. In this short FAQ, DataGen’s Melissa Bauer, principal healthcare informatics analyst, explains:   impartial data in relation to health equity assessment and advancement;   why impartial data are needed; and   how impartial data help hospitals, ambulatory surgery centers and other providers evaluate how healthcare proposals may or may not impact underserved communities.   FAQ 1: What are impartial data?   Third-party data sources and independent entities are to provide impartial data. These data provide an accurate understanding of the potential effects of healthcare initiatives while helping to ensure that supporting data points and, ultimately, decisions are not biased toward the provider. An example of impartial data would include the underserved/marginal population rates for the service area of contracting providers.    FAQ 2: Why is it important to have impartial data?   Organizations need

New facility acquisitions: Preventable SPARCS data scenarios

Many healthcare organizations overlook the importance of mandatory data submissions to New York’s Statewide Planning and Research Cooperative System (SPARCS) when acquiring a new facility. Accurate, up-to-date SPARCS data can give the organizations the most operational horsepower throughout the acquisition process. Accurate SPARCS data ensures compliance, provides guidance and prevents costly delays in expansion plans.  This blog will cover two common SPARCS compliance scenarios* and how they impact facility acquisition. We’ll also highlight how using a data submission platform, like DataGen’s SPARCS submission tool, UDS (UIS Data System™ ), can aid the process.   Scenario 1: Large hospital system acquires a rural facility  Overview  A larger hospital system has acquired a new rural facility. The rural facility has one SPARCS coordinator who handles claims in its healthcare information management department. The rural facility is behind on its SPARCS data submissions, which is causing

Patient Safety Initiatives: 5 Data Factors to Know

The Surveys on Patient Safety Culture™ (SOPS®) take your hospital’s pulse. The results help answer questions like:  Are staff focused on patient safety?  What are our safety results and where can we improve?  How do we take our scores and use them to transform patient outcomes?  How do we build staff confidence?  How do we stress the importance of patient safety?  When used strategically, the required SOPS® survey data can reveal important insights — that go beyond maintaining The Joint Commission accreditation. The Agency for Healthcare Research and Quality offers data collection as a part of the SOPS® survey. Though you’re spending the resources and time to complete this requirement, this effort alone doesn’t improve patient safety. You need to know which safety initiatives to target, followed by the outcomes and impact. A deep dive into the data can deliver that.  In this blog, we'll examine five important factors that impact patient safety data and initiatives, including surve

How to Sustain Effective Medical Home Care Coordination

The National Committee for Quality Assurance defines a patient-centered medical home (PCMH) as “a model of care that puts patients at the forefront.” The PCMH highlights the importance of care coordination and provides pathways to ensure that the medical neighborhood is tangible to the patients served.   The tenants of the medical home ask care teams to treat patients for their medical, behavioral and address their social and economic needs to achieve desired outcomes. As one of the 6 concept areas of the PCMH, it is imperative to implement policies, workflows and partnerships that will promote relationships outside of the primary care setting.   Medical homes are not just care settings but care connectors. Read on to learn:  how to sustain the medical home through effective care coordination;  why practices shouldn’t exclude community-based organizations; and  the key technical components for an effective, sustainable PCMH care coordination model.  Sustaining your medical home through

Community Health Assessment Toolkit: Data Collection Methods

Why should you include data collection methods in your Community Health Assessment (CHA) toolkit? A CHA is like an electronic health record for a county, Metropolitan Statistical Area or region. Done well, the CHA captures clinical and social needs, informs options for new service delivery, facilitates collaboration among community stakeholders and ultimately can impact health outcomes.  Public health departments today must collect data on everything from diabetes outcomes to housing, income, immunizations and many other measures. Read on for the top methods for collecting the most challenging yet insightful data.  Community Health Assessment data collection methods  Like an EHR, the CHA includes defined components. The National Association of County and City Health Officials’ Mobilizing for Action through Planning and Partnerships (MAPP 2.0) model has several components and three assessments under the MAPP 2.0 model Mobilizing for Action through Planning and Partnerships Assessments: 

The 4 benefits of analyzing shadow bundles

Want to supercharge your health and total cost of care strategy? Medicare Accountable Care Organizations can now access CMS shadow bundle data.   This is a unique opportunity for ACOs and clinically integrated networks to reap benefits without assuming any additional financial risk. These benefits include:  improving care delivery;  managing episodes of care within their population; and  promoting engagement with specialists as partners.  If you're ready to do more with your data, continue reading for a complete shadow bundle data overview. We'll examine the four main benefits and discuss how they can help supercharge your analyses. 4 Main shadow bundle benefits  Before we dig in, here’s a brief outline of shadow bundles. Also, use our shadow bundles opportunity analysis info sheet for a quick overview.  What? Shadow bundles capture episodes of care within a defined patient population. CMS’ shadow bundle data for ACOs mirrors the specifications of the Bundled Payments for Care