New agreement between HHS, Pfizer to ensure access to Paxlovid
Editor's Note The US Department of Health and Human Services (HHS) and Pfizer have announced an agreement to extend patient access to the COVID-19 drug Paxlovid, Healthcare Purchasing News October 16 reports. According to the article, Pfizer is readying the drug for more availability in the commercial market in November…
'Million Hearts Model' reduces likelihood of first-time heart attack, stroke
Editor's Note The Million Hearts Model program—an initiative to prevent one million heart attacks and strokes within 5 years—reduced the probability of a first-time myocardial infarction or stroke without significant changes in Medicare spending. The findings were published by JAMA Network on October 12. The Million Hearts Model paid healthcare…
Women neurosurgeons receive half the Medicare reimbursement of male counterparts
Editor's Note From 2013 to 2020, women neurosurgeons received half the reimbursement dollars from Medicare compared to their male counterparts, JAMA Network October 11 reports. This investigative study, titled "Gender differences in Medicare practice and payments to neurosurgeons," was published by JAMA Surgery. The researchers analyzed data for 6,052 neurosurgeons…
ACS: 19 surgical organizations oppose CMS code G2211
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…
Primary care visits linked to decreased postoperative mortality rates
Editor's Note Researchers from the University of Pennsylvania, Philadelphia, find lower mortality rates following emergency general surgery (EGS) in Black and White patients when exposed to primary care prior to the surgical procedure. The retrospective cohort study included 102,384 Medicare patients aged 66 or older who were admitted from the…
CMS proposes changes to price transparency rules, mental health services
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…
Compliance with CMS Hospital Price Transparency Rule linked to financial penalties
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…
Effect of private insurer bundled payment program for total joints on outcomes
Editor's Note This multi-center study led by Humana Inc, Louisville, Kentucky, finds that a bundled payment program offered by a Medicare Advantage insurer for lower extremity joint replacements was associated with reduced spending without changes in quality. A total of 23,034 lower extremity joint replacement surgical episodes (6,355 bundled, 16,679…
CMS: Healthcare spending to reach nearly $7.2 trillion by 2031
Editor's Note This study from the Centers for Medicare and Medicaid Services (CMS) Office of the Actuary (OACT) estimates that US healthcare spending will grow by 5.4% per year on average from 2022 to 2031, now that the COVID-19 public health emergency has ended. Rising from $4.4 to $7.17 trillion,…
US population growing older
Editor's Note The median age of the US population rose to nearly 39 years old in 2020, and the number of those aged 65 and older jumped nearly 33% between 2010 and 2020, according to US Census Bureau data. America’s two largest age groups spurred the changes—more baby boomers turning…
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