Nurse employment and wage trends

Recent news articles have spilled much ink about the current nurse shortage. According to Pew, due to nursing shortages “Hospitals nationwide are canceling nonemergency surgeries, struggling to quickly find beds for patients and failing to meet the minimum nurse-patient ratios experts recommend.” Nursing wages are rising as well. The Baltimore Sun reports that the University…

Teamwork makes the dream work

There is much policy discussion about the need for increased care coordination. AHRQ defines care coordination as “deliberately organizing patient care activities and sharing information among all of the participants concerned with a patient’s care to achieve safer and more effective care.” OECD defines care coordination as “…policies that help create patient-centred care that is…

Quality of Care at Teaching Hospitals

Medicare pays higher reimbursement to teaching hospitals through indirect medical education (IME) payments to hospitals that train a high share of residents. IME inflate standard reimbursements in an attempt to compensate hospitals for these additional costs. Medicare also pay hospitals directly for some cost of training residents through the graduate medical education (GME). A key…

Nursing shortages

While the COVID-19 pandemic continues, the worst part of the pandemic is largely past us (see NYT graph) with more people getting vaccinated. One would expect that as vaccine uptake has risen and cases have fallen, interest in the nursing profession would rise and those who left the nursing profession due to COVID-19 may return.…

CMMI and its revised strategy

Created by Section 3021 of the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Innovation (CMMI; aka The CMS Innovation Center) has been tasked with creating new reimbursement strategies to improve quality and decrease costs. Over the past decade, CMMI has tested over 50 new payment models, and in just the last 3…

GAO Report on MIPS

The Government Accountability Office (GAO) last week published a report evaluating the Merit-based Incentive Payment System (MIPS). MIPS is an approach for CMS to pay physicians caring for Medicare beneficiaries based not just on volume but on value. MIPS evaluates provider value along four dimensions: (1) quality, (2) improvement activities, (3) promoting interoperability, and (4)…