Tag: Medicare

Study: Readmission common after emergency general surgery

Editor's Note Readmission after emergency general surgery procedures is common and varies widely according to patient factors and diagnosis, this study finds. Of more than 177,000 patients analyzed, nearly 6% were readmitted within 30 days. The most common reasons were surgical site infections (16.9%), gastrointestinal complications (11.3%), and pulmonary complications…

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By: Judy Mathias
November 16, 2015
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NIS database used for hospital reimbursement contains major flaws

Editor's Note The Nationwide Inpatient Sample (NIS) database underreports data on patients’ weight, body mass, alcohol use, and tobacco use, finds a study from the Johns Hopkins University School of Medicine, Baltimore. Medicare uses NIS data to set reimbursement rates based on a hospital’s risk for readmissions and surgical complications. The…

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By: Judy Mathias
November 11, 2015
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Medical societies plead with Congress to fix ‘meaningful use’

Editor's Note A coalition of 111 medical societies on November 4 sent letters asking Senate and House leaders to take legislative action to pause Stage 3 of the electronic health records meaningful use program and revise Stage 2 so that it enables provider success, HealthData Management reports. Stage 3 requirements…

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By: Judy Mathias
November 5, 2015
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Medicare releases 2016 final ASC payment rule

Editor's Note On October 30, the Centers for Medicare & Medicaid Services (CMS) released the final 2016 payment rule for ambulatory surgery centers (ASCs). ASC payment rates will increase by 0.3%, which is based on a projected inflation rate of 0.8% minus a 0.5% productivity adjustment required by the Affordable…

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By: Judy Mathias
November 2, 2015
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CMS finalizes 2016 payment rules for physicians, hospitals

Editor's Note The Centers for Medicare & Medicaid Services (CMS) has issued its final rules detailing how it will pay for services provided by physicians and other healthcare professionals in 2016. Key policies finalized in the rules include: Updates to the “Two-Midnight” rule, which clarifies when inpatient admissions are appropriate…

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By: Judy Mathias
November 2, 2015
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Using patient outcomes to assess surgical residency program performance

Editor's Note The 2014 Institute of Medicine report calls for restructuring of Medicare funding for graduate medical education to incorporate pay-for-performance methods. However, to evaluate and financially reward residency programs based on performance, performance must be defined and measurable. This study assesses general surgery residency program performance using outcomes, including…

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By: Judy Mathias
October 29, 2015
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Hospitals with high readmission rates penalized for the patients they serve

Clinical and social characteristics not included in Medicare’s current risk-adjustment methods explained much of the difference in readmission risk between patients admitted to hospitals with higher versus lower readmission rates, a study finds. The Medicare Hospital Readmissions Reduction Program penalizes hospitals with higher than expected 30-day readmission rates by reducing…

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By: Judith M. Mathias, MA, RN
October 28, 2015
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‘Dropless’ cataract surgery could save Medicare billions

Editor's Note Wider adoption of “dropless” cataract surgery could save Medicare more than $7.1 billion over the next 10 years, a new study finds. In addition, patients could save an additional $1.4 billion for out-of-pocket costs for pharmaceutical co-payments, and states could save $124 million in Medicaid payments. The dropless…

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By: Judy Mathias
October 27, 2015
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Differences in 30-day readmission rates after total hips

Editor's Note Researchers found significant differences in the odds of 30-day readmissions after total hip arthroplasties on the basis of race, socioeconomic status, and payer. African American and Hispanic patients had a higher risk of readmissions than white patients. Lower socioeconomic status was linked to higher odds of readmission. Medicare…

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By: Judy Mathias
October 15, 2015
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Effect of hospital safety-net burden on surgical costs, outcomes

Editor's Note In this study on the effect of patient and hospital factors on surgical outcomes and costs at safety-net hospitals, researchers found that hospital resources and not necessarily patient factors lead to inferior outcomes and increased costs. Hospital Compare data from the Centers for Medicare & Medicaid Services website…

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By: Judy Mathias
October 15, 2015
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