Costs & Cost Controls

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February 2018
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Editorial

Efforts in 2017 to dismantle the Affordable Care Act (ACA) were largely unsuccessful, but a tax reform bill that includes a provision to abolish the ACA’s individual insurance mandate seems likely to pass. As a result, 13 million fewer Americans will be insured by 2027, and premiums will go up…

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By: Elizabeth Wood
December 14, 2017
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Impact of reducing postop complications in bariatric Medicare patients

Editor's Note Hospitals with the largest reductions in serious complications after bariatric surgery had the greatest decrease in per-patient Medicare payments, this study finds. Analyzing 37,329 Medicare patients undergoing bariatric surgery from 2005 to 2006 and 2013 to 2014, researchers found a strong association between reductions in complications and decreased…

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By: Judy Mathias
December 12, 2017
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CMS finalizes changes to bundled-payment models

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on November 30 announced a final rule that cancels the mandatory hip fracture and cardiac bundled-payment models, which were to begin on January 1, 2018, and implements changes to the Comprehensive Care for Joint Replacement (CJR) Model. In the final…

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By: Judy Mathias
November 30, 2017
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Cost-benefit analysis of OR air change rates

Editor's Note Increasing OR ventilation rates to improve outcomes and reduce surgical site infections did not provide cleaner air but did increase operating costs in this study. Air quality was measured at different ventilation rates in three ORs. Increasing air change rates did not provide an overall cleaner environment. Significant…

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By: Judy Mathias
November 30, 2017
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Value of voluntary bundled-payment program unclear

Editor's Note For the third year in a row, researchers with the Lewin Group couldn’t determine whether Medicare’s voluntary Bundled Payment for Care Improvement initiative cuts costs and improves care, the October 31 Modern Healthcare reports. The Centers for Medicare & Medicaid Services (CMS) funded analysis found that although providers…

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By: Judy Mathias
November 1, 2017
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Study: No advantages to robotic-assisted nephrectomy

Editor's Note Robotic-assisted nephrectomy is more expensive and takes longer than conventional laparoscopic nephrectomy and confers no additional benefits, this study finds. The proportion of robotic-assisted nephrectomies increased from 1.5% in 2003 to 27% in 2015. Of 23,753 patients analyzed, no significant differences were found in major postoperative complications between…

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By: Judy Mathias
October 31, 2017
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Track ASC metrics to produce a healthy bottom line

Each day seems to bring new tasks for leaders of ambulatory surgery centers (ASCs), adding to their already overflowing plate. One task that can easily fall off that plate is collecting and analyzing metrics, yet failing to do so can have serious financial consequences. OR Manager recently asked ASC leaders…

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By: Cynthia Saver, MS, RN
October 19, 2017
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Low-cost, high-volume services account for most of unnecessary healthcare spending

Editor's Note Low-cost, high-volume healthcare services account for a high percentage of unnecessary spending, adding strain to the healthcare system, this study finds. In this analysis of 5.5 million patients in Virginia, researchers found that services providing no net health benefits cost the state’s healthcare system more than $586 million…

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By: Judy Mathias
October 12, 2017
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Factors linked to readmission after total hip

Editor's Note All-cause readmission is the only metric in widespread use, but it overlooks important information that enables readmission risk to be understood, this study finds. Of 514,455 patients in the UK analyzed over a 10-year period, there were 30,489 all-cause readmissions, 16,499 readmissions related to the surgical site, and…

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By: Judy Mathias
October 5, 2017
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ECRI Institute's new SERVICEguide helps reduce costs of outsourced services

Editor's Note SERVICEguide is the ECRI Institute’s new membership-based advisory service that helps hospitals maintain and manage their outsourced services. SERVICEguide includes an interactive assessment dashboard with spend analytics that reveal the highest potential areas for savings. Recently, for example, ECRI Institute helped a large healthcare system save more than…

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By: Judy Mathias
September 25, 2017
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