CMS releases 2021 proposed payment rule for ASCs, HOPDs
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on August 4 released the 2021 proposed payment rule for ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs). Among the proposals in the rule: CMS proposes to expand the number of procedures that Medicare would pay for when performed…
ASC offsets some revenue loss through 'Hospital Without Walls' waiver
Far fewer cases of COVID-19 have been seen in rural areas of the US than in large urban populations. But even healthcare facilities not inundated with COVID-19 patients have sustained revenue losses and disruptions in standard procedures. One major advantage for Heartland Surgery Center in Kearney, Nebraska, was seeing the…
Proactive payment collection reduces bad debt risk
Establishing policies to collect payment before surgery has grown in importance as high-deductible health plans impose larger out-of-pocket costs on patients. To help manage patients’ expectations about costs and increase the likelihood of collecting payment, some experts believe a culture shift is in order. They say healthcare facilities should be…
Effect of total joint bundled payment program on patient selection
Editor's Note In this study, researchers found little to no significant change in the characteristics of patients having total hip and knee replacement surgery after the Centers for Medicare & Medicaid Services introduced the mandatory bundled payment programs in selected metropolitan statistical areas. The analysis included a matched set of…
CMS proposes changes to total joint bundled payment program
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on February 20 issued a rule proposing changes to the Comprehensive Care for Joint Replacement (CJR) program, which bundles payments to acute care hospitals for hip and knee replacement surgical procedures. CMS proposes extending the CJR model for an additional…
Medicare may overpay for postop care
Editor's Note Medicare may be overpaying surgeons for postoperative care they provide to patients, according to a new Rand Corporation analysis in the January 23 New England Journal of Medicine. The authors of the analysis suggest that federal officials should incorporate ways to more objectively measure the amount of postoperative…
CMS proposes giving Medicare patients better access to cutting-edge devices
Editor's Note In its proposed rule, the Centers for Medicare & Medicaid Services (CMS) would give Medicare patients better access to innovative devices beginning next year, the July 30 MassDevice reports. CMS also says it might pay more for “certain transformative new devices” for inpatients, using a new technology add-on…
CMS maintains site-neutral cuts in 2020 proposed rule
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on July 29 issued the 2020 proposed payment rule for ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs), which would increase Medicare hospital outpatient prospective payment system rates by 2.7%. CMS is also proposing to add eight codes to…
Interactive surgical playbook expands OR team synergy
OR leaders spend much of their day ensuring the surgery schedule runs smoothly, a task that depends on the teams within each of the ORs. Highly functioning teams produce optimal results, including good patient outcomes, satisfied surgeons, and efficient use of resources. But developing a highly functional team with good…
CMS: New online tool compares cost differences for outpatient procedures
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on November 27 launched a new online tool that compares Medicare payments and co-payments for certain outpatient surgical procedures performed in hospitals and ambulatory surgery centers. The “Procedure Price Lookup” tool will help Medicare patients consider potential cost differences when…
