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VA finds shorter stays don’t lead to readmissions

Hospitals have been under pressure to reduce costs and send patients home earlier, and there has been speculation that shorter stays would mean more re-admissions. But a 14-year study of Veterans Affairs hospitals found that reducing a patient’s stay does not increase the chance that person will be readmitted later. Researchers studied more than 4 million admissions from 1997 to 2010 in 129 VA hospitals. Hospital lengths of stay dropped 27%, and readmission rates after 30 and 90 days went down by 16%. Mortality rates at 30 and 90 days decreased by 3%. The study was published in the Dec. 18, 2012, issue of Annals of Internal Medicine. Reducing the length of a hospital stay can have positive effects for the patient as well as a hospital’s bottom line, he said. “Every day someone sits in a hospital bed is one more day they can get an infection,” said Peter Kaboli, MD, lead author of the study, who conducted the research with colleagues from the Iowa City VA Medical Center ...

Rule change lets House ignore Medicare IPAB

Any recommendation sent to Congress by the Medicare Independent Payment Advisory Board likely will never be taken up by the Republican-controlled House. The House adopted rules for the 113th Congress that included a provision addressing the IPAB’s authority to make recommendations on Medicare payment policy. The House rules are an attempt to nullify provisions in the Affordable Care Act “that limit the ability of the House to determine the method of consideration for a recommendation from” IPAB. “The rules package will better enable us as an institution to perform our constitutional duties and obligations with integrity and transparency, while streamlining our operations,” House Rules Committee Chair Pete Sessions (R, Texas) said in a statement. House Republicans, who have controlled the chamber since 2011 and will do so at least through 2014, have voted numerous times to repeal the 2010 health system reform law or eliminate certain sections. The IPAB was authorized ...

Demand rises for CME linked to physician quality improvement

As physicians face increasing pressure to demonstrate performance improvement, more are utilizing a model of continuing medical education that gives them tools to assess the care they provide patients, and make measurable enhancements. The concept of Performance Improvement Continuing Medical Education was introduced in the early 2000s, and the model has expanded significantly since then. In 2011, 44,275 physicians and 7,492 nonphysician health professionals participated in 502 PI CME activities offered in the U.S., according to the Accrediting Council for Continuing Medical Education. That’s a steep increase from the 744 physicians and 175 nonphysician health professionals who participated in 22 PI CME activities offered just six years earlier. The model makes up a small fraction — less than 1% — of the more than 132,000 CME activities offered nationwide. But demand for PI CME is expected to grow as the country shifts to a pay-for-performance system of care that emphasizes ...