Implications of reimbursement for postop complications on quality, value
Editor's Note Postoperative complications add an important marginal cost to Medicare payments and lead to a substantial portion of payments to hospitals, this study finds. Analyzing Medicare data for three procedures from 2009 to 2012, payments per uncomplicated surgical procedure were $13,500 for colectomy, $12,300 for total knee arthroplasty, and…
Study: Most hospitals received penalties for excess readmissions
Editor's Note More than half of hospitals were penalized by the Centers for Medicare and Medicaid Services in all five years of the Hospital Readmission Reduction Program (HRRP) initiated by the Affordable Care Act, this study finds. Among the study findings: Penalties doubled since the beginning of the program, from…
CMS releases proposed FY 2018 inpatient payments, policies
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on April 14 issued a proposed rule that would update FY 2018 Medicare inpatient payments and policies. Among the changes, the rule: would increase payment rates by 1.6%, after accounting for inflation and other adjustments required by law includes an…
CMS interim rule delays bundled payment programs
Editor's Note In an interim final rule, the Centers for Medicare and Medicaid Services (CMS) has delayed expansion of the Comprehensive Care for Joint Replacement (CJR) bundled payment program and implementation of its bundled payment programs for cardiac care from July 1 to October 1, 2017, the March 20 Modern…
Effect of opt-out policy for physician supervision of anesthesia
Editor's Note Opting out of the Medicare rule that requires anesthesia to be administered with physician supervision has little or no effect on access to inpatient or outpatient surgery, this study finds. The researchers also found that opting out does not reduce costs, and in fact increases costs for inpatient…
Hospital teaching status and Medicare payments, outcomes
Editor's Note Risk-adjusted Medicare payments for an episode of surgical care were similar at teaching and nonteaching hospitals for three complex surgical procedures, this study finds. Teaching vs nonteaching hospital payments included: abdominal aortic aneurism repair−$29,946 vs $27,993 pulmonary resection−$25,407 vs $26,813 colectomy−$34,949 vs $30,352. Very major teaching hospitals had…
CMS extends deadline for reporting 2016 quality data
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on January 17 announced a deadline extension for reporting CY 2016 electronic Clinical Quality Measure data to avoid a 2.7% payment adjustment in FY 2018. The extension applies to hospitals and critical access hospitals participating in the Hospital Inpatient Quality…
Adding new business to the ASC, one procedure at a time—Part 1
An ambulatory surgery center (ASC) looking to expand its market may want to add new procedures, but only after careful consideration of resource investment versus ultimate benefit. In the first of a three-part series, OR Manager explores surgical specialties that appear to show promise for the outpatient setting. One of…
Care after surgery drives costs
Editor's Note This study finds that where surgical patients go after they are discharged varies widely, and that variation leads to huge differences in how much their care costs. Variation in postacute care spending between lowest and highest quintiles differed 129% for total hip replacement, 103% for coronary artery bypass…
New administration likely to intervene in bundled-payment initiatives
Editor's Note The Centers for Medicare & Medicaid Services (CMS) issued a final rule December 20, 2016, on its cardiac and orthopedic bundled-payment initiatives, but President-elect Donald Trump’s nominee for Health and Human Services secretary, Rep Tom Price (R-Ga) is likely to stop the cardiac mandatory initiative scheduled to start…
Free Daily News
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- The Joint Commission makes nurse staffing a national performance goal for 2026
- Telehealth in limbo: Providers split on continuing Medicare services during shutdown
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- Nearly half of US physicians now work for large systems: GAO links consolidation to higher costs