Charging

Latest Issue of OR Manager
October 2017

Price transparency tool did not reduce spending for California public employees, retirees

Editor's Note Offering a price transparency tool to California public employees and retirees that focused on services such as lab tests, office visits, and advanced imaging services did not lower spending, this study finds. Only 12% of employees used it in the first 15 months after it was introduced, and…

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By: Judy Mathias
September 5, 2017
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Editorial

The inaugural Bundled Payment Bootcamp on June 20 in Nashville, Tennessee, was a timely opportunity for healthcare providers to learn how reimbursement is changing the way they do business. Though the uncertain direction of US healthcare legislation continues to cause consternation, this workshop—which will be presented again in fall 2017—clarifies…

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By: Elizabeth Wood
July 13, 2017
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Hospital teaching status and Medicare payments, outcomes

Editor's Note Risk-adjusted Medicare payments for an episode of surgical care were similar at teaching and nonteaching hospitals for three complex surgical procedures, this study finds. Teaching vs nonteaching hospital payments included: abdominal aortic aneurism repair−$29,946 vs $27,993 pulmonary resection−$25,407 vs $26,813 colectomy−$34,949 vs $30,352. Very major teaching hospitals had…

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By: Judy Mathias
February 10, 2017
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Huddles help hospitals move toward the goal

Like a football team gathering to confirm tactical details before a play, surgical staff often form a huddle to ensure readiness of the providers, patient, and equipment for the upcoming procedure. In a twist on the traditional huddle the day before surgery, staff at the Hospital of Central Connecticut (HOCC)…

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By: OR Manager
December 14, 2016
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Hospitals still using chargemaster markups to improve revenue

Editor's Note Since Medicare adopted its prospective payment system in 1985, many hospital executives and economists have suggested that the hospital chargemaster (list of prices for all hospital procedures and supplies) is irrelevant. However, in this study, researchers found that hospitals are systematically adjusting their charge-to-cost ratios (ie, chargemaster price…

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By: Judy Mathias
September 12, 2016
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Bundled payments: Part and parcel of value-based care

Government and third-party payers are pushing for value-based, rather than volume-based, models of care, yet few hospitals are moving that direction, a survey shows. The Centers for Medicare & Medicaid Services (CMS) requires that half of hospitals’ payments be value based by 2018, according to a 2016 Health Catalyst survey…

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By: OR Manager
September 2, 2016
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Surgical volume rising along with staff vacancies, survey shows

OR leaders continue to face increases in volume and staffing mobility, according to the 2016 annual OR Manager Salary/Career Survey. The volume of surgical procedures in the past 12 months increased for slightly more than half of respondents (51%), compared to 43% in 2015. In terms of staffing, respondents noted…

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By: OR Manager
August 8, 2016
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Help decode ICD-10 for prompt reimbursement

Despite warnings of calamities, implementation of the International Classification of Diseases (ICD)-10 on October 1, 2015, proceeded smoothly, with minimal impact on denied claims. In the fourth quarter of 2015, the percentage of Medicare claims denied was 10%, comparable to the preimplementation figure of 9.9%. But that doesn’t mean OR…

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By: OR Manager
August 8, 2016
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Creativity holds keys to competency assessment

How can leaders of ambulatory surgery centers (ASCs) ensure they have a competent staff? First, they must hire staff with the right skill sets, and then they should implement meaningful methods for ongoing assessment. Here are some strategies for meeting these goals.   Begin with the hiring process “When you…

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By: OR Manager
August 8, 2016
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Transparent pricing: Way of the future for surgery centers

Editor's Note The Monticello Community Surgery Center, Charlottesville, Virginia, is posting prices of outpatient procedures on its website, the July 22 CBS 19 reports. The center’s CEO Andy Poole calls it the “wave of the future of healthcare.” Though the center takes insurance and Medicare, knowing the total cost of…

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By: Judy Mathias
July 26, 2016
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