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Medicare to Pay for Care Coordination
For the first time, Medicare will reimburse providers for the time they spend coordinating care for beneficiaries with two or more chronic conditions, such as diabetes, heart failure, or depression. The policy change will go into effect in January 2015. To receive the care coordination payments (about $42 a month), providers will need to create comprehensive care plans; assess patients’ medical, psychological, and social needs; check whether they are taking medications as prescribed; monitor the care provided by other doctors; and make arrangements to ensure smooth transitions when patients move from a hospital to their home or to a nursing home. Notably, doctors or members of their staff also will need to be available to patients 24/7 to deal with urgent questions. The American College of Physicians was among the medical groups that, while welcoming the government's recognition of the importance of this work, suggested that this level of payment is too low.

CMS Proposes New Quality Measures for ACOs in 2015
Unplanned admissions for patients with diabetes, heart failure, or multiple chronic conditions are among the patient outcomes that accountable care organizations (ACOs) participating in the Medicare Shared Savings Program may have to begin tracking next year. As the Centers for Medicare and Medicaid Services (CMS) shifts its performance reporting away from care processes to outcomes, it has proposed adding these and other measures to the set now reported by the some 300 ACOs participating in the program. ACOs may also have to track whether their patients are admitted to skilled nursing facilities within 30 days of being discharged, a sign that CMS is beginning to hold ACOs accountable for patient care across settings. Under the proposed rules, ACOs that show improvement on quality measures year after year will be eligible for bonus payments, on top of shared savings.

Hospitals Invited to Preview Data for New Payment Measures for Heart Failure, Pneumonia Episodes
CMS is giving hospitals a chance to preview their performance data on two new measures designed to facilitate comparisons of the value of care provided for heart failure and pneumonia. The costs of care for these conditions can vary widely among hospitals, even though evidence-based care protocols exist. The two measures—risk-standardized payment associated with a 30-day episode of heart failure and risk-standardized payment associated with a 30-day episode of pneumonia—will be incorporated into the Inpatient Quality Reporting program and publicly reported beginning in fiscal year 2015. From Sept. 8 to Oct. 7, hospitals and quality improvement organizations will have an opportunity to preview hospital-level, state, and national performance data on these two new measures on Quality Net

Recommendations for Fixing the U.S. Mental Health Care System
A commentary published in the Journal of the American Medical Association recommends reforms of the U.S. mental health care system needed to identify and treat patients with serious mental illness in the community and avoid hospitalizations and incarcerations triggered by untreated or poorly treated mental illnesses. The article also advocates for greater involvement of patients' families and changes to privacy laws to facilitate their involvement, as well as care coordination and public education about acute mental illness. Two bills in Congress seek to address some of these issues: The Helping Families in Mental Health Crisis Act (HR 3717) and The Strengthening Mental Health in Our Communities Act of 2014 (HR 4574).

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