Medicare

Latest Issue of OR Manager
October 2017

Survey: Physicians unprepared for MACRA

Editor's Note A survey of 1,000 physicians by the American Medical Association and KPMG finds that fewer than one in four believe they are well prepared to meet the 2017 requirements of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), KPMG.com reported on June 28. MACRA reshapes how…

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By: Judy Mathias
July 5, 2017
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Study characterizes ED visits after total joint procedures

Editor's Note Emergency department (ED) visits after total joint procedures were numerous and mostly for pain-related diagnoses, and Medicaid patients had almost double the risk of an ED or pain-related ED visit, this study finds. Of 152,783 patients analyzed, 3.42% returned to the inpatient setting and 5.81% visited the ED…

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By: Judy Mathias
June 28, 2017
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Value-based purchasing not linked to improvements in quality

Editor's Note In this study, Medicare’s Hospital Value-Based Purchasing (HVBP) program was not associated with improvements in quality measures of clinical process or patient experience. HVBP also was not associated with a significant reduction in two of three mortality measures (ie, acute myocardial infarction or heart failure). It was associated…

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By: Judy Mathias
June 16, 2017
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Half million providers to get 2% cut in Medicare payments

Editor's Note More than 500,000 physicians and other providers will get a 2% cut in their Medicare payments because of poor performance in the Physician Quality Reporting System (PQRS), the June 13 Modern Healthcare reports. The penalties are based on 2015 claims data. Though Medicare is phasing out PQRS and…

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By: Judy Mathias
June 14, 2017
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Relationship between bariatric surgery outcomes and Medicare expenditures

Editor's Note Medicare payments for bariatric surgery are significantly lower at hospitals with low complication rates, and cost savings are most prominent in patients at highest risk for complications, this study finds. The analysis of 38,374 bariatric surgery patients found a strong correlation between complication rates and episode payments−hospitals in…

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By: Judy Mathias
June 12, 2017
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Racial disparities in surgical mortality narrowing

Editor's Note Despite concerns that quality improvement efforts may widen disparities, national racial disparities in surgical mortality are narrowing, this study finds. Using Medicare claims data from 2005 to 2014, Harvard researchers found that, overall, national mortality trends improved for both black and white patients by 0.10% and 0.07% per…

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By: Judy Mathias
June 12, 2017
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US Representatives ask Secretary Price’s assistance with ASC inflationary update measure

Editor's Note A bipartisan group of 24 US Representatives sent a letter to Department of Health and Human Services Secretary Tom Price, MD, on May 26 asking him to use his statutory authority to move ambulatory surgery centers (ASCs) from the Consumer Price Index for All Urban Consumers (CPI-U) to…

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By: Judy Mathias
June 6, 2017
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AHRQ releases stats on outpatient, inpatient surgeries

Editor's Note According to statistics from the Agency for Healthcare Research and Quality (AHRQ), in 2014, 17.2 million hospital visits (inpatient and outpatient) included surgical procedures. More than half (57.8%) occurred in a hospital-owned outpatient surgery setting, and the remaining (42.2%) were inpatient. Private insurance was the primary payer for…

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By: Judy Mathias
June 2, 2017
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CMS issues guide for quality payment programs

Editor's Note The Centers for Medicare & Medicaid Services (CMS) has issued a guide summarizing technical assistance resources available to small, underserved, and rural hospitals participating in the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model (AAPM). The guide also provides resources for quality innovation networks and…

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By: Judy Mathias
June 2, 2017
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National Advocacy Day leads to new cosponsors for ASC legislation

Editor's Note The Ambulatory Surgical Center Quality and Access Act of 2017 (HR 1838/S 1001) has added new cosponsors in the US House of Representatives and was introduced in the Senate, the May 23 Ambulatory Surgery Center Association (ASCA) News Digest reports. Many of the cosponsors signed on as a…

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By: Judy Mathias
May 23, 2017
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