Costs & Cost Controls
2026 ICD-10 updates bring hundreds of new codes, new complexity
Editor's Note Healthcare providers, payers, and analytics teams face sweeping ICD-10 changes this fall, with the 2026 code updates taking effect October 1, 2025, Wolters Kluwer July 14 reports. The release includes 614 new codes, 12 invalidations, 642 billability changes, 88 terminology revisions, and the creation of an entirely new…
Mind the gap: Why Medicare pays ASCs less than HOPDs—and what that means
For decades, ambulatory surgery centers (ASCs) have shown their ability to deliver high-quality surgical care at substantially lower cost than hospital outpatient departments (HOPDs). ASCs achieve these savings through leaner operations, streamlined staffing models, and specialty-focused efficiencies, not by compromising safety or outcomes. Studies consistently highlight procedures performed in ASCs…
ASCs face growing pressure to centralize implant management as specialty volumes surge
Ambulatory surgery centers (ASCs) are taking on more high-acuity, same-day procedures than ever before. This growth is driven by evolving clinical protocols, cost-conscious reimbursement strategies, and expanded capabilities in outpatient care. Specialties like orthopedics, spine, ophthalmology, and cardiovascular care are moving more complex cases—and the implants that come with them—out…
Hospital margins improve as outpatient revenue accelerates, but costs loom
Editor's Note Hospital operating margins rose in June as outpatient revenue growth fueled stronger financial performance, though rising bad debt and non-labor expenses continue to pressure stability, according to Kaufman Hall’s latest National Hospital Flash Report. HealthLeaders August 18 covered the findings. As detailed in the article, the median year-to-date…
Health systems lean toward established partners for AI adoption
Editor's Note Most US health systems are choosing artificial intelligence (AI) tools from vendors already connected to their electronic health record (EHR) systems rather than from new, standalone AI startups, Modern Healthcare August 14 reports. The findings come from a July survey of 233 health systems conducted by the Healthcare…
Healthcare providers express cash flow concerns under new 340B rebate model
Editor's Note Healthcare providers could experience significant cash flow and operational changes under a new voluntary pilot program that fundamentally alters how the nation's second-largest drug payment program operates, according to an August 11 article in Modern Healthcare. As detailed in the article, The Health Resources and Services Administration announced…
Hospital margins stable despite rising drug, supply costs
Editor's Note US hospitals and physician practices demonstrate steady financial performance through the second quarter of 2025, with health system operating margins holding at a median 1.2% year-to-date, according to new data from Strata Decision Technology analyzing more than 1,850 hospitals and 152,000 physicians. DotMed reported the news August 4,…
Study: Loophole enables urban hospitals to qualify for rural subsidies
Editor's Note Hundreds of urban hospitals have obtained dual urban-rural Medicare classifications since a 2016 policy change, enabling them to qualify for reimbursement programs intended for rural providers. Fierce Healthcare reported the news August 4. As detailed in the article, a study published in Health Affairs by Johns Hopkins and…
July poll results: Perioperative leaders are tackling labor costs, staffing flexibility
Perioperative leaders often have to make critical decisions, not just in the middle of an operational crisis but also somewhere in the edges—the routine but still high-stakes moments where leaders need to adjust resources or absorb costs under tight constraints. The economic margin for error continues to narrow, and many…
Fast-track ENT days boost surgical volume, cut backlog at UCSF Benioff Children’s
Editor's Note Designating underused neurosurgery blocks for straightforward ENT procedures increased surgical volume and reduced wait times at UCSF Benioff Children’s Hospital San Francisco, according to a July 3 report from the Children’s Hospital Association’s 2025 Transforming Quality Conference. The initiative began in early 2024, when ENT leaders and surgical…
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- Surgical robotics market accelerates as new players challenge industry giants
- Robotic surgery boosts 3-year relapse-free survival in rectal cancer
- Low-cost simulation helps surgical trainees practice crisis skills for major hemorrhage
- Nurse leaders weigh in on NCLEX pass rate decline, impact on workforce readiness
- FDA issues early alerts on multiple high-risk device recalls from J&J, Medtronic, Baxter, Boston Scientific
- New UCSF measure shows 1 in 60 cesarean deliveries involve serious surgical complications
- Hospitals can curb costly post-acute discharges with targeted periop programs, study finds
- Sameness in nursing care puts patients at risk
- CMS’s plan to phase out inpatient-only list could bolster rural ASCs
- AAAHC unveils v44 standards to sharpen focus on patient-centered ambulatory care