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First ACOs Earn Accreditation from NCQA
Earlier this month, the National Committee for Quality Assurance announced that six physician/hospital networks have received accreditation as accountable care organizations (ACOs). They are: The Billings Clinic of Billings, Mont.; Children's Hospital of Philadelphia Care Network; Crystal Run Healthcare of Middletown, N.Y.; Essentia Health of Duluth, Minn.; HealthPartners of St. Paul, Minn.; and Kelsey-Seybold Clinic of Houston, Tex. The NCQA accreditation review process assesses an organization's structure; network of providers; access to patient-centered primary care; care management and coordination; patients' rights and responsibilities; and performance reporting and quality improvement.

CMS to Require All-Cause Readmissions Reporting
As reported this month by HealthLeaders Media, CMS is beginning to lay out its future policies governing reporting requirements for hospital readmission rates. Starting this July, hospitals will be required to report hospital-wide all-cause unplanned readmission rates; they will also have to report readmission rates among patients undergoing total hip or knee replacements. Currently, hospitals report rates only for patients admitted for heart failure, heart attack, or pneumonia, but observers had expected CMS to change the policy as way to encourage safe discharge for all patients—not just those targeted for reporting and the associated financial penalties. 

AMA Suggests Role for Ambulatory Providers in Ensuring Safe Care Transitions
A new report from the American Medical Association (AMA) outlined five responsibilities for ambulatory care providers in ensuring safe and effective care transitions between hospital and home. These responsibilities include assessment, goal-setting, support for self-management, medication management, and care coordination. While much attention has been paid to hospitals' responsibilities to prepare patients for discharge, less attention has been paid to the role of community providers, even though such providers are responsible for providing ongoing care.

Report: Little Progress in Reducing Readmissions
Readmission rates among Medicare patients fell only a little from 2008 to 2010, according to a Robert Wood Johnson Foundation/Dartmouth Atlas report released earlier this month. In 2010, one of eight (12.4 percent) Medicare patients was readmitted to the hospital within 30 days of being released after surgery, while one of six (15.9 percent) patients hospitalized for reasons other than surgery was readmitted. Both rates were little different than those recorded in 2008 (12.7 percent for surgical readmissions and 16.2 percent for other readmissions), in spite of significant attention to the issue among hospitals, communities, and health care payers. The data also showed continued variability in readmission rates across the nation and among hospital types. The surgical 30-day readmission rate was 12.7 percent in 2008 and 12.4 percent in 2010, while the medical 30-day readmission rate was 16.2 percent in 2008 and 15.9 percent in 2010.

Choosing Wisely Campaign Grows: 135 Commonly Used Treatments and Procedures Included 
Seventeen different professional societies have now joined the American Board of Internal Medicine Foundation's Choosing Wisely campaign, altogether identifying 135 medical tests, treatments, or procedures that physicians and their patients should question the necessity of—up from 45 last April when the list was first published. New to the list are procedures such as early elective deliveries and CT scans for children with head injuries—the kinds of treatments that experts say may be necessary in rare cases but do not offer benefit in most and may even cause harm.

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