Insurance

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April 2021
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Use of telehealth by surgical specialties before, during COVID-19

Editor's Note This study led by the University of Michigan, Ann Arbor, finds that early in the COVID-19 pandemic, there was a substantial increase in telehealth use across all surgical specialties, with a slow decline after June 2020. Of 4,405 surgeons included in the study, 2,588 (58.8%) used telehealth in…

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By: Judy Mathias
April 5, 2021
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Hospitals ramp up outpatient TJA in the COVID-19 era

Fueled by a pandemic, patient demand, and competition with ambulatory surgery centers (ASCs), hospital outpatient department (HOPD) leaders are feeling the push to offer same-day discharge for total joint arthroplasty (TJA). Outpatient TJA is nothing new, but it’s certainly growing in popularity, says John W. Stirton, MD, MBA, medical director…

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By: Jennifer Lubell
March 19, 2021
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Bundled payments with copay waivers reduce surgery costs for patients, payers

Editor's Note A RAND Corporation study published in the March Health Affairs finds that health insurers and patients can achieve significant savings when they participate in a bundled payment program that waives cost-sharing for patients. Researchers examined a bundled payment program developed by a private insurer that ran from 2016…

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By: Judy Mathias
March 2, 2021
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More states report telehealth reimbursement laws

Editor's Note A Foley & Lardner survey finds that state telehealth reimbursement laws have significantly increased during the COVID-10 pandemic, but more can be done to address telehealth adoption barriers, the February 15 Revcycle Intelligence reports. More than 43 states and Washington, DC, have some telehealth statute for commercial payers,…

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By: Judy Mathias
February 18, 2021
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CMS: How to prepare for COVID-19 vaccine

Editor's Note The Centers for Medicare and Medicaid Services (CMS) on November 5 released a set of toolkits and enrollment actions to take to administer the COVID-19 vaccine when it’s available. Many Medicare-enrolled providers don’t have to take any actions until the vaccine is available. Some Medicare-enrolled providers must also…

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By: Judy Mathias
November 5, 2020
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CMS issues coverage plan for COVID-19 vaccines, treatments

Editor's Note The Centers for Medicare and Medicaid Services (CMS) on October 28 issued an interim final rule that requires CMS to cover any COVID-19 vaccines that receive Food and Drug Administration (FDA) authorization at no cost to beneficiaries. The rule also will increase what Medicare pays hospitals for COVID-19…

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By: Judy Mathias
October 29, 2020
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National Academies release COVID-19 vaccine distribution proposal

Editor's Note The National Academies of Sciences, Engineering, and Medicine, on September 1, released draft guidelines to help policymakers plan for equitable allocation of a COVID-19 vaccine. The committee that drafted the guidelines was formed at the request of the National Institutes of Health and Centers for Disease Control and…

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By: Judy Mathias
September 2, 2020
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Preoperative protocols enhance outpatient total joint outcomes

On January 1, 2020, the Centers for Medicare & Medicaid Services (CMS) began reimbursing healthcare providers for total hip arthroplasty performed in outpatient hospital settings and total knee arthroplasty in ambulatory surgery centers (ASCs), thereby opening the floodgates for explosive growth in outpatient total joint arthroplasty (TJA). About a million…

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By: Catherine Spader, RN
July 22, 2020
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Joint Commission revises standards to align with CMS requirements

Editor's Note The Joint Commission announced July 1 that it has made two sets of standards changes for deemed-status hospitals and critical access hospitals. The first set of changes, which went into effect July 1, was made in response to hospital deeming renewal applications with the Centers for Medicare &…

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By: Judy Mathias
July 9, 2020
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COVID-19 hospitalization costs could reach $17B this year

Editor's Note A new Avalere analysis estimates the cost of COVID-19 hospitalizations could range between $9.6 billion and nearly $17 billion this year, depending on infection and hospitalization trends, the June 23 Fierce Healthcare reports. The analysis considers the cost of hospitalizations in three scenarios: $9.6 billion, if there is…

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By: Judy Mathias
June 24, 2020
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