Hospitals are working to deal with the CMS' latest quality measure, Medicare spending per beneficiary, which will link hospital payments to the performance of other providers, including hospices. Dr. Leora Horwitz of Yale University School of Medicine said hospitals may not see how cost and quality issues that occur in other facilities are something they can control, but "CMS is taking the long view, trying to change the underlying incentive structure that enables these changes to take place."

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