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A flurry of new CMS qual­ity re­port­ing mea­sures has hos­pi­tals won­der­ing how much strain the new re­quire­ments will mean for their in­sti­tu­tions. “We em­brace re­port­ing and be­ing mea­sured for the care we pro­vide to our pa­tients, but a lot of these mea­sures are weakly linked to sci­ence and are sub­ject to a lot of vari­a­tion,” says Alex Hover, left, of St. John’s Health Sys­tem. “We’re go­ing to need a lot of clar­i­fi­ca­tion.”

CMS ac­tu­ar­ies pre­dict that na­tional health ex­pen­di­tures will rise over the next 10 years by $311 bil­lion un­der the new health­care law, but warned that the ac­tual im­pact is highly un­cer­tain and that scores of pro­vi­sions in the pack­age aim to re­duce the cost of care. That’s $77 bil­lion more than an ear­lier as­sess­ment of the ver­sion of the re­form pro­posal the Se­nate ap­proved in De­cem­ber, which served as the core of the leg­is­la­tion that was signed into law in March. Un­der the ear­lier pro­posal, fed­eral ac­tu­ar­ies said ex­pen­di­tures would in­crease $234 bil­lion over the next decade. While the dol­lar amount is dif­fer­ent, the un­der­ly­ing rea­sons for the in­crease are the same. The CMS ex­pects that ex­panded cov­er­age will lead to greater use of health­care ser­vices cou­pled with lower fed­eral pay­ments to providers.

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