Medicare

Latest Issue of OR Manager
August 2020

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: Cynthia Saver, MS, RN
July 22, 2020
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US House of Representatives moves to expand the use of telehealth beyond COVID-19

Editor's Note Leaders of the US House of Representatives telehealth caucus introduced legislation on July 16 to permanently open up access to telehealth services for Medicare patients, the July 16 Fierce Healthcare reports. The bipartisan bill will eliminate restrictions on use in Medicare patients, and it will provide a bridge…

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By: Judy Mathias
July 20, 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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CMS issues call to action based on new COVID-19 data for Medicare patients

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on June 22 called for a renewed commitment to value-based care based on Medicare claims data that provides an early snapshot of the effect of the COVID-19 pandemic on the Medicare population. Medicare patient data, from January 1 to May…

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By: Judy Mathias
June 25, 2020
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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…

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By: Elizabeth Wood
June 17, 2020
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CMS to make some pandemic telehealth provisions permanent

Editor's Note The Centers for Medicare & Medicaid Services (CMS) administrator Seema Verma says use of telehealth has grown dramatically during the COVID-19 pandemic, and some provisions that were extended temporarily will be made permanent, the June 2 Becker’s Hospital Review reports. During the pandemic, CMS expanded access to telehealth…

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By: Judy Mathias
June 3, 2020
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CMS unveils enhanced enforcement actions for nursing homes based on COVID-19 data, inspections

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on June 1 unveiled enhanced enforcement actions for nursing homes with violations of infection control practices. The enhanced and targeted accountability actions are based on trends in recent data regarding the incidence of COVID-19 in nursing homes and infection control…

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By: Judy Mathias
June 2, 2020
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CMS releases proposed inpatient payment rule for FY 2021

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on May 11 released a proposed rule that increases Medicare inpatient prospective payment system (IPPS) rates by a net of 3.1% in FY 2021, compared to 2020, for acute care hospitals participating in the Hospital Inpatient Quality Reporting Program that…

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By: Judy Mathias
May 13, 2020
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Best practices back proactive antimicrobial stewardship in ASCs

Hospitals have long dominated the realms of infection control and antibiotic overuse. Ambulatory surgery centers (ASCs), which typically release patients the same day of a procedure, use antibiotics less frequently than other facilities, and most do not have an antimicrobial stewardship program. However, some ASC leaders and organizations are encouraging…

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By: Jennifer Lubell
March 16, 2020
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Outcomes, costs of Medicare patients having surgery at teaching vs nonteaching hospitals

Editor's Note This study of Medicare patients at 340 teaching hospitals and matched patient controls at 2,444 nonteaching hospitals found that as risk of mortality increased, the mortality benefit of treatment at teaching hospitals also increased, though with marginally higher costs. Included in the analysis were 86,751 pairs of general,…

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By: Judy Mathias
March 9, 2020
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