Editor’s Note  In this luncheon presentation, OR Manager Conference attendees delved into the Centers for Medicare & Medicaid Services Quality Measure Reporting Program for ambulatory surgery centers (ASCs).  Gina Throneberry, MBA, RN, CASC, CNOR, director of education and clinical affairs at the Ambulatory Surgery Center Association (ASCA), shared which quality…

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Editor's Note This study, led by researchers at Wake Forest University School of Medicine, Winston-Salem, North Carolina, examines whether Affordable Care Act Medicaid expansion among Black, Hispanic, and White patients led to reductions in preventable hospitalizations. Data on census population and hospitalizations for ambulatory care sensitive conditions from 2010 to…

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Editor's Note The Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act, which is set to take effect in 2025, will set up a separate Centers for Medicare and Medicaid Services (CMS) payment for certain nonopioid pain management techniques in outpatient and ambulatory surgery center (ASC) settings, the September 12 Becker’s…

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Editor's Note The Joint Commission, on August 23, announced that updated Accelerate PI Dashboard Reports are available for hospitals, critical access hospitals, and nursing centers. The reports provide performance measurement data from the Centers for Medicare and Medicaid Services on a select subset of quality measures through the second quarter…

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Editor's Note The Joint Commission, on August 9, announced that it is revising a performance measure for the advanced Total Hip and Total Knee Replacement (THKR) Certification Program—THKR-5: Postoperative Functional/Health Status Assessment—to align with a similar Centers for Medicare and Medicaid Services (CMS) measure. The recently adopted CMS performance measure—Hospital-Level,…

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Editor's Note The American College of Surgeons (ACS) announced, on July 26, that it and 18 other surgical organizations sent a letter to the Centers for Medicare & Medicaid Services (CMS), strongly opposing implementation of its code G2211. The G2211 code is an effort by CMS to pay more for…

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Takeaways • Healthcare consumers are not aware that they can ask how much something costs. • There is disconnect between the law and common knowledge, and patients generally are confused about what they receive as good faith estimates. • In addition to incorrect CPT codes and OON allowable charges, the…

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Editor's Note On July 13, the Centers for Medicare & Medicaid Services (CMS) issued a proposal that would increase Medicare hospital outpatient prospective payment system rates by a net 2.8% in 2024 compared to 2023, including a “proposed 3% market basket update, offset by a 0.2% cut for productivity,” the…

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Editor's Note The Joint Commission, on July 12, announced that it is making several changes to its critical access hospital (CAH) elements of performance (EPs) to better align with the Centers for Medicare and Medicaid Services (CMS) Conditions of Participation, effective August 27, 2023. The changes are part of CMS’…

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Editor's Note This study from Harvard Medical School, Boston, and Georgetown University, Washington, DC, finds that hospital compliance with the Centers for Medicare & Medicaid Services (CMS) 2021 Price Transparency Rule is increasing since financial penalties were enforced. Data from 4,377 acute care hospitals operating in 2021 and 2022 were…

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