Costs & Cost Controls

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February 2019
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Effect of Medicare ACOs on spending for inpatient surgery

Editor's Note Though Medicare Accountable Care Organizations (ACOs) have had some success in reducing spending for medical care, they have not had similar success with surgical spending, this study finds. Of 341,675 patients at 427 ACO hospitals and 1,024,090 patients at 1,531 non-ACO hospitals analyzed, average baseline payments were similar…

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By: Judy Mathias
January 14, 2019
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Surgical VAC mines new software for deeper look at products

After transitioning from a paper-based data and operations management system to one that uses relational database software, Lahey Hospital and Medical Center (LHMC) in Burlington, Massachusetts, saved more than $1 million in product purchases in 2017. The surgical value analysis committee (VAC) evaluated 150 product requests and managed the conversion…

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By: Robert Dolan, MD,, Kristen Murphy, MBA, and Edward Aiello
January 14, 2019
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Medicare’s bundled payments for joint replacements show moderate savings

Editor's Note In the first 2 years of Medicare’s Comprehensive Care for Joint Replacement (CJR) program, there was a modest reduction in spending per procedure without an increase in complication rates, this study finds. Comparing costs associated with 280,161 joint replacement procedures in 803 hospitals required to participate in the…

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By: Judy Mathias
January 3, 2019
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Effect of routine preop urine screening on postop outcomes

Editor's Note Antimicrobial treatment of asymptomatic organisms identified in preoperative urine cultures was not associated with reductions in the risk for postoperative infections, including urinary tract infections (UTIs) and surgical site infections (SSIs), this study finds. In this analysis of 68,265 patients in 109 Veterans Affairs hospitals who had cardiac,…

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By: Judy Mathias
January 2, 2019
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Editorial

A greater focus on cost cutting and improving quality of care, a rise in outpatient procedures, and increased demand for cost and quality transparency were among the major healthcare trends projected for 2018. It’s safe to say these will continue to dominate in 2019 and beyond. A year ago, all…

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By: Elizabeth Wood
December 13, 2018
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Effect of CJR bundled payment program on care delivery

Editor's Note Participation in the Comprehensive Care for Joint Replacement (CJR) bundled payment program was associated with changes in care delivery and compensation practices, this study finds. This survey of 73 orthopedic surgeons found that those practicing in CJR hospitals were more likely to report their hospitals had implemented programs…

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By: Judy Mathias
December 6, 2018
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Comprehensive ROI pitch helps to procure OR equipment

Multiple requests for new equipment and technology—usually from surgeons but also sometimes from staff—are not uncommon. As part of their due diligence, OR leaders must determine whether the return on investment (ROI) justifies the purchase. Doing ROI calculations systematically—and involving key stakeholders—can help ensure that the organization makes the best…

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By: Cynthia Saver, MS, RN
November 14, 2018
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Effect of prehabilitation program on abdominal surgery patients

Editor's Note Colectomy patients participating in a preoperative prehabilitation program had positive physiologic effects and experienced fewer complications, this study finds. The prehabilitation program−Michigan Surgical and Health Optimization Program (MSHOP)−engages patients in four activities before surgery: Physical activity, pulmonary rehabilitation, nutritional optimization, and stress reduction. For the study, patients were…

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By: Judy Mathias
October 30, 2018
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Value stream redesign: The cornerstone of excellent patient care

Many healthcare organizations have adopted Lean processes to save money, improve workflow, and reduce waste. But it’s not just process change that drives success. It’s the individuals—especially those on the front lines—who work together to identify problems and solutions. It’s also ongoing efforts to sustain changes once they have been…

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By: Elizabeth Wood
October 18, 2018
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CMS: 1,299 providers join new bundled payment initiative

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on October 9 announced that 1,299 healthcare providers are participating in its new Bundled Payments for Care Improvement−Advanced model, which began October 1 and will continue until December 31, 2023. The program includes 32 bundled clinical episodes (29 inpatient, 3…

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By: Judy Mathias
October 11, 2018
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