Editorial
The French proverb, “the more things change, the more they stay the same,” is one way to view the readmission penalties imposed by the Centers for Medicare & Medicaid Services (CMS). About a year ago, a Kaiser Health News report said more than 2,600 hospitals in fiscal year 2015 were…
CMS extends “Two-Midnight” rule partial enforcement delay to end of year
Editor's Note The Centers for Medicare & Medicaid Services on August 12 extended the partial enforcement delay of the “Two-Midnight” rule from September 30 to December 31, AHA News reports. The extension prohibits Recovery Audit Contractors from conducing post-payment patient status reviews for claims with admission dates October 1 to…
Variation in surgical readmissions mostly patient related
Editor's Note Postoperative readmissions occurred in more than 1 in 10 patients, in this study, with considerable variation across specialties. The majority of variation was attributable to patient-related factors (82.8%); surgical specialty accounted for 14.5% of the variability, and individual surgeon factors accounted for 2.8%. After adjusting for patient and…
US Senate passes Electronic Health Fairness Act
Editor's Note The US Senate on August 5 passed the Electronic Health Fairness Act of 2015 (S 1347), which was heavily promoted by the Ambulatory Surgery Center Association. The legislation protects physicians practicing in ASCs from Medicare meaningful use penalties until a certified electronic health record technology is available for…
Medicare penalizes more than half of hospitals for readmissions
Editor's Note Nearly 2,600 hospitals will be penalized for missing readmission targets under Medicare, with a loss of $420 million, Kaiser Health News reports. The average Medicare payment reduction is 0.61% per patient stay; 38 hospitals will receive the maximum cut of 3%. The reductions are based on readmissions of…
ACS Advocating for Critical Access Hospital Relief Act
Editor's Note A central issue discussed at the US House Committee on Ways and Means on July 28 was the Critical Access Hospital (CAH) Relief Act, HR 169, which is supported by the American College of Surgeons (ACS). Currently, for CAHs to receive Medicare Part A reimbursement, physicians must certify…
ASA survey: Who bears responsibility for reducing healthcare costs?
Editor's Note A survey of members of the American Society of Anesthesiologists on the level of responsibility they perceive stakeholders to have in reducing the cost of healthcare and perioperative care delivery found: physicians bear “major responsibility” (38%) physicians bear “some responsibility” (58%) physicians bear “no responsibility” (4%) hospitals bear…
Medicare patient mortality, hospitalizations, and expenditures down
Editor's Note Deaths, hospital stays, and spending all decreased for Medicare patients from 1999 to 2013, this study finds. In 1999, the all-cause mortality rate was 5.3%, and by 2013 that rate had fallen to 4.5%. Hospitalizations decreased from around 35,000 per 100,000 annually to 27,000 per 100,000. Inpatient inflation-adjusted…
Senate bill would let Medicare patients self-pay for medical devices
Editor's Note Four US Senators (two democrats, two republicans) are sponsoring legislation—The Accelerating Innovation in Medicine (AIM) Act—that would increase Medicare patients’ access to new medical devices. Currently, Medicare patients who are interested in self-paying for a device not covered by Medicare face significant administrative obstacles. Under AIM, once a…
Medicare trust fund exhausted by 2030
Editor's Note A report from Medicare trustees on July 22 projects that the Medicare trust fund will be exhausted in 2030. The report also revealed that recipients of Social Security disability benefits could face steep cuts next year. The fund it expected to run out of money in 2016. Congress…
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