CMS, the Veterans Health Administration, and some states measure our care quality based on risk-adjusted readmission rates after inpatient admissions. In fact, up to 3% of our hospital’s Medicare inpatient revenue (used to pay physician subsidies) is at risk if we don’t manage our patients’ readmissions in concert with Medicare’s algorithms.
An audit of Medicare Part B payments from 2014 through 2016 revealed that CMS improperly paid providers more than $66.3 million for specimen validity tests billed in combination with urine drug tests, according to a report by the OIG.
Electronic health records fall short of early promises that they would reduce administrative costs, a recent study found. The cost of completing insurance- and billing-related activities in the EHR can represent more than a quarter of professional reimbursement for an emergency department visit.
The expected growth in healthcare expenditures from 2017 to 2026 is expected to outpace the growth in gross domestic product (GDP) by 1%, resulting in an increase in the health share of the GDP from 17.9% in 2016 to 19.7% in 2026, according to a CMS report.
