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Top 20 most expensive inpatient conditions

Editor's Note Septicemia was the most expensive condition treated in US hospitals in 2013, according to the Agency for Healthcare Research and Quality. Others in the top 20 most expensive were: osteoarthritis, 2nd complications of device, implant, or graft, 4th complications of surgical procedures or medical care, 13th hip fracture,…

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By: Judy Mathias
June 15, 2016
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Healthcare providers struggling to transition to VBP

Editor's Note Moving to information systems and data requirements of the new value-based payment (VBP) reimbursement system is proving to be a daunting challenge for healthcare providers, the June 13 Health Data Management reports. A survey of healthcare executives from 190 hospitals shows that only 3% of respondents provide more…

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By: Judy Mathias
June 14, 2016
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ASCs reduce cost of outpatient surgery by $38 billion per year

Editor's Note An analysis of US commercial health insurance claims found ambulatory surgery centers (ASCs) reduce the cost of outpatient surgery by more than $38 billion per year compared to hospital outpatient departments, the Ambulatory Surgery Center Association said in a June 14 report. The study, which included more than…

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By: Judy Mathias
June 14, 2016
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Reminder: July 1 is deadline to apply for 'meaningful use' hardship exception

Editor's Note Eligible hospitals, critical access hospitals, and professionals who did not achieve "meaningful use" in the Medicare Electronic Health Record Incentive Program for the 2015 reporting period have until July 1 to apply for a hardship exception from the 2017 payment adjustment.   The streamlined hardship applications reduce the…

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By: Judy Mathias
June 13, 2016
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CMS releases alert on new ICD-9, ICD-10 exclusions

Editor's Note The Centers for Medicare & Medicaid Services (CMS) released an alert May 23 on newly excluded ICD diagnosis codes that will no longer be accepted starting January 7, 2017. The codes include: T88.8XXA (Other specified complications of surgical and medical care, not elsewhere classified, initial encounter) T88.8XXD (Other…

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By: Judy Mathias
June 2, 2016
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NYC hospital downsizing in response to changes in care models

Editor's Note New York City’s (NYC’s) 825-bed Mount Sinai Beth Israel hospital will close in 4 years and be replaced by a much smaller 70-bed facility while expanding outpatient surgery, primary care, and behavioral health services, the May 25 New York Times reports. Officials blame the high cost of health…

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By: Judy Mathias
June 1, 2016
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Vulnerable hospitals and unintended consequences of the Affordable Care Act

Editor's Note Vulnerable status of hospitals is linked to higher readmission rates after major cancer surgery, this study finds. Of 355 hospitals analyzed, safety net hospitals and high Medicaid hospitals had higher 30-day, 90-day, and repeated readmissions. The findings reinforce the need to account for socioeconomic variables in risk adjustments…

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By: Judy Mathias
May 31, 2016
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Cost-effectiveness of free colonoscopy for high-risk uninsured

Editor's Note Performing free colonoscopies for uninsured patients at high risk for colorectal cancer can identify cancers at an earlier stage and is cost neutral for a health system, this study finds. Of 682 uninsured patients screened, 9 cancers ( 1 stage 0, 3 stage I, 2 stage II, and…

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By: Judy Mathias
May 26, 2016
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Effects of Medicare bundled payments for colectomy

Editor's Note In this study from Johns Hopkins, Baltimore, payments for colectomy under Medicare’s Bundled Payments for Care Improvement Initiative were lower than a fee-for-service payment model, and the proportion of patients contributing to a net negative margin increased. Net negative margins were calculated as the difference between total hospital…

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By: Judy Mathias
May 19, 2016
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Surgery at critical access hospitals safe, less expensive

Editor's Note In this study, Medicare patients having common surgical procedures at critical access hospitals had no significant difference in 30-day mortality than those at noncritical access hospitals (5.4% vs 5.6%), and they had lower rates of serious complications (6% vs 14%) and lower expenditures ($14,450 vs $15, 845). The…

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By: Judy Mathias
May 18, 2016
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