Readmission Rules for Medicare 2018



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Readmission Rules for Medicare 2018

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DEPARTMENT OF HEALTH AND HUMAN SERVICES … – CMS.gov

www.cms.gov

The Centers for Medicare & Medicaid Services (CMS) SNF Value-Based
Purchasing (VBP). Program is one of … CMS will withhold 2 percent of SNF
Medicare payments starting October 1, 2018, to fund the incentive payment pool
readmission data is collected from SNFs and there are no additional reporting
requirements.

SNF VBP Program FY 2018 Final Rule NPC – CMS.gov

www.cms.gov

Nov 16, 2017 Program Fiscal Year (FY) 2018 Final Rule. Presenter: Celeste … The Skilled
Nursing Facility Value-Based Purchasing (SNF VBP) Program offers Medicare
incentive payments to … The SNFRM estimates risk-standardized rate of all-
cause, unplanned hospital readmissions of Medicare SNF beneficiaries …

(FY) 2018 Inpatient Prospective Payment System (IPPS) – CMS.gov

www.cms.gov

Oct 18, 2017 Change Request (CR) 10273 implements policy changes for the Fiscal Year (FY)
2018 Inpatient. Prospective Payment … FY 2018 Final Rule Data Files webpage:
https://www.cms.gov/Medicare/Medicare-Fee- ….. The readmissions payment
adjustment factors for FY 2018 are in Table 15 of the FY 2018.

Quality Payment Program Year 2 – CMS.gov

www.cms.gov

stakeholder comments and are finalizing many of the proposed policies from the
calendar year. (CY) 2018 Quality Payment Program proposed rule. Because we
want to continue to receive your feedback, this is a final rule with comment period
. The Quality Payment Program makes major changes to how Medicare pays …

Hospital Value-Based Purchasing – CMS.gov

www.cms.gov

The Hospital Value-Based Purchasing (VBP) Program is a Centers for Medicare
& Medicaid Services. (CMS) initiative that … Care Coordination. * Beginning with
FY 2018, the Care Transition measure will add three questions to the HCAHPS
Survey. … (IPPS)/Long-Term Care Hospital (LTCH) Final Rule. The HCAHPS
Pain …

Computation of the 2018 Value Modifier Fact Sheet – CMS.gov

www.cms.gov

The Value-Based Payment Modifier (Value Modifier) adjusts Medicare Physician
Fee. Schedule (PFS) payments …. Medicare PFS Proposed Rule (81 FR 46408-
46409 and 46446-46448), CMS has proposed a …. Readmission measure
requires at least 200 eligible cases to be included in the Quality Composite and
applies …

Medicare Shared Savings Program Interaction with the 2018 Value …

www.cms.gov

Organizations (ACOs). The 2018 Value Modifier adjusts Medicare Physician Fee
Schedule (PFS) payments to … Readmission measure calculated by Medicare for
the 2016 performance period, and patient experience data for … a proposal that
was included in the 2018 Medicare Physician Fee Schedule Proposed Rule (82.

Skilled nursing facility services – Medicare Payment Advisory …

www.medpac.gov

The Congress should eliminate the market basket updates for 2018 and 2019
and direct the. Secretary to revise the prospective … Report to the Congress:
Medicare Payment Policy | March 2017. Skilled nursing facility services …… the
Congress enacted a SNF readmission policy, with facilities to begin publicly
reporting …

Medicare Claims Processing Manual – CMS.gov

www.cms.gov

20.1.2.6 – Time Value of Money. 20.1.2.7 – Procedure for Medicare contractors to
Perform and … 20.4.9 – Admission Prior to and Discharge After Capital PPS.
Implementation Date. 20.4.10 – Market Basket … 30 – Medicare Rural Hospital
Flexibility Program and Critical Access Hospitals (CAHs). 30.1 – Requirements for
CAH …

Conditions With the Largest Number of Adult Hospital Readmissions

www.hcup-us.ahrq.gov

Apr 1, 2014 http://www.rwjf.org/content/dam/web-assets/2011/10/medicare-hospital-
readmissions-reduction-program. Accessed … Table 2 lists the 10 conditions with
the most all-cause, 30-day readmissions for Medicare patients aged. 65 years …..
Uninsured: includes an insurance status of "self-pay" and "no charge.".

HMSA Plan – OPM

www.opm.gov

See page 15 for requirements. This Plan has … average, expected to pay out as
much as the standard Medicare prescription drug coverage will pay for all plan
participants and is considered … However, if you choose to enroll in Medicare
Part D, you can keep your FEHB coverage and your FEHB plan will coordinate …

Report to the Congress: Medicare Payment Policy

waysandmeans.house.gov

May 18, 2017 By law, the Medicare Payment Advisory Commission reports to the Congress
each March on the Medicare … payment policy in 2018 for acute care hospital,
physician and other health professional … incentives to reduce excessive
hospital readmission rates and a unified payment system for post-acute care …

9 Surgical Site Infection (SSI) Event – Centers for Disease Control …

www.cdc.gov

Jan 1, 2018 January 2018. 9-2. Procedure-associated Module. SSI. For example, these
methods include: • Review of medical records or surgery clinic patient records o
Admission, readmission, ED, and OR logs o Patient charts for signs and
symptoms of SSI o Lab, X-ray, other diagnostic test reports o Nurses and …

DDB Data Dictionary_October 2017 – Medicare Data – Medicare.gov

data.medicare.gov

System Requirements Specification. Hospital Compare ….. readmission, patient
experience, effectiveness of care, timeliness of care, and efficient use of medical
imaging. The hospitals can …. for the FY 2018 recalibrated PSI measures only
represent the 15-month performance period of ICD-9 claims. (7/1/14 to 9/30/15).

TABLE OF CONTENTS – SCDHHS.gov

www.scdhhs.gov

Jan 1, 2018 A hospital is defined as a general acute care institution licensed as a hospital by
the applicable South Carolina licensing authority and certified for participation in
the. Medicare (Title XVIII) Program. All hospitals must be enrolled in the South
Carolina. Medicaid Program. In-state hospitals must also contract.

RAI Spotlight – Padona

sais.health.pa.gov

Aug 5, 2016 Medicare Spending Per Beneficiary. (FY 2018): Evaluates a given PAC provider's
Medicare spending relative to that of the national median PAC pro- vider in the
same setting. The costs measured are incurred during the SNF stay (admission to
discharge) and the associated services period which ends.

Federal Requirements and State Options: Provider Payment – macpac

www.macpac.gov

Mar 1, 2017 Federal Requirements and State Options: Provider Payment. States have
considerable flexibility to design their own Medicaid payment methods and set
their own payment rates (Table 1). States make direct payments to providers
under fee-for-services arrangements; they make capitation payments to …

Estimated Federal Savings Associated with Care Coordination …

www.healthandwelfare.idaho.gov

As of 2010, over 9 million individuals were eligible for both Medicare and
Medicaid—the dual eligibles. …. A major target for team based care is reducing
preventable admissions and readmissions through …. would be more consistent
with a policy that would require dual eligibles to enroll in health plans and other
care …