American journal of medical quality : the official journal of the American College of Medical Quality
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The relative contribution of long-term acute care hospital (LTACH) to short-term acute care hospital (STACH) Medicare patient readmissions is important because of the high acuity of LTACH patients. A retrospective cohort study was conducted to determine the magnitude of LTACH Medicare heart failure (HF) and pneumonia (PN) inpatient readmissions to STACHs within 30 days of LTACH admission and the relative contribution of LTACH patient readmissions to each STACH's total readmissions. ⋯ An average of 8% HF and 8% PN LTACH Medicare inpatients were readmitted to host or primary referral STACHs within 30 days of admission, representing 0.4% and 0.8% of the total number of HF and PN Medicare patients, respectively, readmitted to the STACHs in fiscal year 2010. The low rates of readmission from LTACHs to STACHs suggest an appropriate level of care for the LTACHs studied.
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The Centers for Medicare and Medicaid Services (CMS) introduced the Physician Quality Reporting System (PQRS) in 2007. PQRS was developed as a value-based, pay-for-reporting initiative intended to increase quality and decrease costs. Jefferson University Physicians (JUP) was an early participant in this voluntary program. ⋯ Net incentives earned across JUP in 2010 topped $171 000, although these earnings were significantly offset by implementation and maintenance costs. PQRS represents CMS's first step toward aligning quality and cost in the ambulatory care setting. Faculty practice plans must be prepared to meet this challenge in order to avoid future penalties and to advance quality of care.