CMS payment overhaul could cut specialist pay
Editor's Note A “quiet transformation” in how Medicare pays doctors could reduce payments for specialty care, including rates for billing codes associated with surgery, diagnostic imaging, outpatient care, pain management, and orthopedics, Modern Healthcare July 22 reports. According to the article, The Centers for Medicare and Medicaid Services (CMS) 2026…
Providers call for deeper reform despite CMS proposing payment hikes in 2026
Editor's Note CMS is boosting 2026 Medicare outpatient payments by 2.4%, but provider groups warn the increase barely scratches the surface of mounting financial strain. Alongside the payment bump, the agency is proposing a two-track physician reimbursement model that ties rates to value-based care participation. While some see these moves…
Anesthesia costs squeeze ASCs as staffing shortages, reimbursement gaps widen
Editor's Note Ambulatory surgery centers (ASCs) continue to face a mounting anesthesia crisis: costs are rising, staffing is tightening, and reimbursement is failing to keep pace. Anesthesia payments have dropped 8.2% over the past decade, while provider salaries have risen by as much as 40%, creating a growing financial burden…
Rehab hospitals face scrutiny over safety, profits
Editor's Note Although for-profit rehab hospitals have become highly profitable, a recent KFF Health News report highlights serious safety violations, including patient deaths due to carbon monoxide poisoning, medication errors, and falls. Published July 15, the article delves into recent data and inspections of these facilities, particularly those run by…
CMS 2026 proposed rule: Expanded ASC access, higher payments, tighter quality reporting
Editor's Note The Centers for Medicare & Medicaid Services (CMS) just proposed sweeping changes to the Medicare Shared Savings Program and Physician Fee Schedule for calendar year 2026, including extensive changes to outpatient Medicare policy such as payment increases, expanded procedural access, and new quality reporting updates, as outlined in…
CMS proposes 2026 Medicare pay bump, targets wasteful spending
Editor's Note The Centers for Medicare & Medicaid Services (CMS) has proposed a 3.62% increase to the 2026 Medicare physician fee schedule, according to a July 14 article in Fierce Healthcare. The proposed rule sets the conversion factor at $33.42, up from $32.35 in 2025. The increase reflects a 2.5%…
ASC adaptability depends on properly structured leadership
Takeaways • Different types of ASC leadership structures can be adapted to meet organizational needs. • Regulations, accreditation standards, size, and ownership types are examples of factors influencing the leadership structure. • Ongoing success of the ASC leadership team depends on factors such as governing body diversity and strategic planning.…
The Joint Commission announces accreditation overhaul
Editor's Note The Joint Commission has launched a major redesign of its healthcare accreditation and certification programs with Accreditation 360: The New Standard. According to a June 30 announcement, the new framework introduces outcome-focused performance tools, eliminates hundreds of requirements, and promises to made standards publicly accessible. Reportedly supported by…
DOJ task force, insurers target ASC barriers with parallel reforms
Editor's Note Federal regulators and major insurers are independently moving to ease long-standing burdens on ambulatory surgery centers (ASCs), potentially reshaping the regulatory and administrative landscape in which perioperative leaders operate. According to Ambulatory Surgery Center News June 23, ASC stakeholders are actively engaging with the new Anticompetitive Regulations Task…
Medicaid data shared with DHS to aid immigration enforcement
Editor's Note The Trump administration ordered federal health officials this week to share personal data from Medicaid enrollees with deportation authorities, the Associated Press (AP) reported June 14. According to the report, the Centers for Medicare and Medicaid Services (CMS) was given just 54 minutes on Tuesday to transfer enrollee…
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