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What We're Reading: Hospital Penalization; New APMs; EHR Challenges
More than 700 hospitals were penalized for having the highest rates of patient injuries; the Physician-focused Payment Technical Advisory Committee backed 2 new alternative payment models; and experts outline the biggest challenges of implementing and maintaining electronic health records going into the new year.
751 Hospitals Penalized for Patient Injuries
The government lowered a year’s worth of Medicare payments to 751 hospitals in response to them having the highest rates of patient injuries. According to Kaiser Health News, half of the hospitals were also penalized last year through the penalty, which began 4 years ago through the Affordable Care Act. The program was created as a financial incentive for hospitals to avert infections and other adverse events such as blood clots and bed sores.
Two New APM Models Gain Approval
The Physician-focused Payment Technical Advisory Committee (PTAC) backed plans for 2 new alternative payment models, recommending them to HHS, reported MedPageToday. The 2 new payment models include a capitated model for primary care and 1 for end-stage renal disease (ESRD). The capitated model, from the American Academy of Family Physicians, was recommended for limited-scale testing, and the episode payment model submitted by the Renal Physicians Association targets the first 6 months of dialysis for ESRD patients.
Biggest EHR Challenges Going into 2018
In an article on Healthcare IT News, experts described the biggest challenges hospitals and health systems will face in 2018 while implementing and maintaining their electronic health records. One expert cited cybersecurity as one of the leading challenges, with large amounts of data being at risk for cybersecurity threats. Other major challenges hospitals and health systems will face in the coming year include continued focus on interoperability, the rise of value-based care in the healthcare industry, and information overload and clinician burnout.
Care Quality Metrics in Medicare During COVID-19 Pandemic
August 12th 2025Medicare Advantage outperformed traditional Medicare on clinical quality measures before and during the COVID-19 pandemic; mid-pandemic, however, traditional Medicare narrowed the gap on some in-person screenings.
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Laundromats as a New Frontier in Community Health, Medicaid Outreach
May 29th 2025Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.
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The Legal Architecture of Psychedelic Therapy: Risks, Responsibilities, and Reimbursement Realities
July 30th 2025Key legal, ethical, and compliance considerations for managed care professionals navigating the evolving landscape of psychedelic-assisted therapy include regulatory risks, data privacy challenges, reimbursement limitations, and the need for culturally informed care models.
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