Costs & Cost Controls

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October 2017
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Editorial

Since July, when repeal and replacement of the Affordable Care Act (ACA) stalled, healthcare reform has been somewhat overshadowed by events such as natural disasters and concerns about national security. Now, with insurers due to announce rates for the coming year, Congress is working on a bill to stabilize the…

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By: Elizabeth Wood
September 20, 2017
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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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California county goes surgery shopping

Editor's Note California's Santa Barbara County and other government employers are joining private employers in shopping for lower-cost bundled surgical care, even if it means going out of town, the September 1 Kaiser Health News reports. The voluntary program that includes incentives such as waived copays and deductibles as well…

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By: Judy Mathias
September 5, 2017
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Costs vary widely for common surgical procedures

Editor's Note There is wide cost variation for five common surgical procedures in the US, this study finds. Cost observed-to-expected ratios ranged widely: 14.9-fold for colectomy 5.5-fold for coronary artery bypass graft (CABG) 12.5-fold for lung resection 10.6-fold for total knee arthroplasty 28.0-fold for cesarean section. High-cost hospitals were more…

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By: Judy Mathias
August 30, 2017
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Payment variation in CABG episodes of care can affect bundled payments

Editor's Note Wide variation was found in 90-day coronary artery bypass grafting (CABG) episode payments for Medicare and private payer patients in this study. The differences were driven by increased use of evaluation and management services, higher utilization of inpatient rehabilitation, and patients with multiple readmissions. In the analysis of…

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By: Judy Mathias
August 25, 2017
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Voluntary bundled-payment models shifting to outpatient procedures

Editor's Note Though the Centers for Medicare & Medicaid Services (CMS) is rolling back mandatory bundled-payment programs, it is expected to release more voluntary, outpatient-focused programs, which shifts power from hospitals to physicians, the August 21 Healthcare Finance News reports. Physician-focused does not require a hospitalization, which creates a complete…

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By: Judy Mathias
August 24, 2017
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Obese cardiac surgery patients use more ICU resources

Editor's Note After cardiac surgery, obese patients required significantly more ICU resources and longer recovery times, resulting in more expensive, labor-intensive care, this study finds. Of 5,365 patients included in the analysis, 1,948 were classified as obese. Patients with greater obesity were: four times more likely to have longer time…

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By: Judy Mathias
August 10, 2017
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AHRQ: Cost trends for inpatient stays

Editor's Note From 2005 to 2014, the average inflation-adjusted cost of a hospital inpatient stay increased by 12.7%, from $9,500 to $10,900, according to new statistics from the Agency for Healthcare Research and Quality (AHRQ). Average costs for stays increased: 16% for Medicaid 18% for private insurance 8% for Medicare…

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By: Judy Mathias
August 2, 2017
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ECRI Institute announces new white paper on value analysis

Editor's Note The ECRI Institute on July 31 announced a new free white paper titled, “Value Analysis: Best Practices for Navigating the Evidence Maze. The white paper features three case studies that show how hospital value analysis committees can use the PICOTS (patients, intervention, comparators, outcomes, time frame for follow-up,…

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By: Judy Mathias
August 1, 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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