Health Care Reform

Latest Issue of OR Manager
September 2020
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Culture, communication, and clinical skills essential for ERAS success

Strategies that can achieve the aims of excellence in clinical care, fewer complications, and reduced costs are sorely needed, and the comprehensive implementation of an Enhanced Recovery After Surgery (ERAS) program can help achieve these aims in the surgical population. ERAS pathways have been found to reduce morbidity, hospital stay,…

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By: OR Manager
July 22, 2020
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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…

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By: Judy Mathias
February 24, 2020
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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…

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By: Judy Mathias
February 24, 2020
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Association of geriatric-specific characteristics with postop readmissions

Editor's Note In this study from the University of Virginia, new geriatric-specific characteristics were found to raise the risk of elderly surgical patients having unplanned readmissions within a month of leaving the hospital. The four geriatric-specific risk factors for readmission include: cognitive impairment requiring another person to sign the patient’s…

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By: Judy Mathias
February 19, 2020
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Implications of the rapid growth of NPs in the US workforce

Editor's Note Concerns about physician shortages have led policy makers to advocate for the greater use of nurse practitioners (NPs). From 2010 to 2017, the number of NPs more than doubled from 91,000 to 190,000, this analysis finds. The growth of NPs, which occurred in every region of the US,…

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By: Judy Mathias
February 13, 2020
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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…

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By: Judy Mathias
January 23, 2020
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Study challenges concerns about HRRP

Editor's Note This study from the division of cardiology at Dallas’ University of Texas Southwestern Medical Center and the Yale School of Medicine, New Haven, Connecticut, challenges concerns about Medicare’s Hospital Readmission Reduction Program (HRRP)--ie, that it leaves patients more vulnerable and increases postdischarge mortality rates. Analyzing inpatient and outpatient…

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By: Judy Mathias
January 16, 2020
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Spending, quality effects of Medicare’s bundled payments for lower-extremity joint replacement

Editor's Note In this study, researchers found that over a 3-year period, compared to no participation, participation in Medicare’s Bundled Payments for Care Improvement (BPCI) program was associated with a 1.6% decrease in average lower extremity joint replacement spending with no changes in quality, driven by early participants. When looking…

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By: Judy Mathias
January 7, 2020
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House passes year-end bill that repeals ACA taxes including medical device tax

Editor's Note The US House of Representatives on December 17 passed a year-end spending bill that repeals several Affordable Care Act (ACA) taxes, including the 40% tax on generous health insurance plans and the 2.3% tax on the sale of medical devices, the December 17 Reuters reports. The bill also…

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By: Judy Mathias
December 18, 2019
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Hospital-based care coordination strategies linked to CMS star ratings

Editor's Note Care coordination strategies were found to be associated with high overall hospital quality star ratings from the Centers for Medicare & Medicaid Services (CMS) in this study. A total of 710 general acute care noncritical access hospitals that received star ratings and responded to the 2015 American Hospital…

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By: Judy Mathias
November 21, 2019
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