Current Report Articles
Federal Focus

Federal Focus (May 15, 2020) – NIHCM Highlights Increase in Mortality Rates Involving Stimulants
A new Data Insights published by the National Institute for Health Care Management highlights the rapid rise in overdose deaths involving cocaine and methamphetamine, illustrates the geographic variations in utilization and death rates, and quantifies the increasing burden that these drugs are placing on the hospital system. Key findings include the following:

  • As the number of opioid overdose deaths soared from 17,268 to 45,865 throughout the 2008-2018 period, stimulants increasingly were involved in these deaths as well.
  • In 2008, only 2.5 percent of all opioid deaths (436/17,268) had co-involvement of methamphetamine. A decade later, this share had grown to 13.6 percent (6,260/45,865) for a 10-year increase of more than 440 percent.

CMS Releases Medicare IPPS and LTCH Proposed Rules
The Centers for Medicare & Medicaid Services released proposed rules and a fact sheet for the Medicare Inpatient Prospective Payment System and the Long-Term Care Hospital payment system.

MLN Connects Provider eNews Available
The Centers for Medicare & Medicaid Services issued updates to MLN Connects Provider eNews. eNews includes information about national provider calls, meetings, events, announcements and other MLN educational product updates. The latest issue provides updates and summaries of the following:

  • COVID-19: modified ordering requirements for laboratory billing
  • Hospital Outpatient Prospective Payment System: new coronavirus specimen collection code
  • Home health plans of care: nurse practitioners, CNSs and physician assistants allowed to certify
  • CMS announces independent commission to address safety and quality in nursing homes

NIH Study Highlights Importance of Hospital-Initiated Interventions for Mitigating Suicide Risk
A study funded by the National Institutes of Health found that patients who visited the emergency department for an opioid overdose were 100 times more likely to die by drug overdose in the year after being discharged and 18 times more likely to die by suicide relative to the general population. Additionally, in the year after ED discharge, patients who visited for a sedative/hypnotic overdose had overdose death rates 24 times higher, and suicide rates nine times higher, than the general population. The findings, published in the American Journal of Preventive Medicine, highlights the need for interventions that reduce suicide and overdose risk that can be implemented when patients come to the ED.

Maternal Mental Health Awareness: Screening Tools Available
With the incidence of postpartum depression affecting one in eight women, recommendations for screening for perinatal mood disorders are coming from a growing number of organizations. The U.S. Preventive Services Task Force and the Centers for Medicare & Medicaid Services, as well as the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics, all recommend screening.

ACOG's recommendation specifically identifies the Edinburgh Postnatal Depression Scale and notes it is the most frequently used in the clinical setting for several reasons. It is comprised of 10 self-reported questions, takes less than five minutes to complete, has been translated into more than 50 different languages, and also addresses anxiety symptoms, which can be common in perinatal mood disorders.

ACOG also recognizes other screening instruments, such as the Patient Health Questionnaire (PHQ-9), the Beck Depression Inventory and the Center for Epidemiologic Studies Depression Scale. However, these screening instruments do not specifically screen for perinatal depression.

The AAP recommends utilizing the EPDS screening tool during an infant's one-, two-, four- and six-month visits, and then transitioning to the PHQ-2 screening tool beyond the postpartum period.