Tag: Outpatient procedures

Study: Medicare Advantage surgical episodes cost less, achieve similar quality as traditional Medicare

Editor's Note Medicare Advantage (MA) patients undergoing elective surgery incurred lower costs than comparable patients in traditional Medicare (TM) without higher readmission rates and with no significant difference in mortality rates, according to a study published August 1 in JAMA Health Forum. The findings suggest that MA plans reduce surgical…

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By: Matt Danford
August 6, 2025
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Celebrate National ASC Month with exclusive OR Manager insights

Editor's Note As we begin National Ambulatory Surgery Center (ASC) Month, we’ve been reflecting on all OR Manager has to offer this critical subset of our audience—and all that is yet to come.   First, why celebrate ASCs, and how to get involved? According to the Ambulatory Surgery Center Association…

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By: Matt Danford
July 31, 2025
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Study: Physician organizational affiliation impacts procedure locations, costs

Editor's Note Hospital-employed physicians are least likely and private equity (PE)-affiliated physicians most likely to provide care in lower-cost ambulatory surgery centers (ASCs) or offices, according to a study published July 24 in the Journal of Market Access & Health Policy These care site differences translate to substantial variation in…

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By: Matt Danford
July 30, 2025
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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…

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By: Matt Danford
July 24, 2025
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CMS 2026 proposed rule: Expanded ASC access, higher payments, tighter quality reporting

Centers for Medicare & Medicaid Services

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…

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By: Tarsilla Moura
July 16, 2025
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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.…

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By: Cynthia Saver, MS, RN
July 1, 2025
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Health systems retreat from partnerships to control costs, refocus on core care

Editor's Note Some health systems are cutting ties with long-standing partners to conserve resources, brace for financial uncertainty, and prioritize core clinical services, Modern Healthcare June 26 reports. With looming federal reimbursement cuts and increasing economic pressures, providers are reassessing the value and sustainability of affiliations formed during more stable…

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By: Tarsilla Moura
June 27, 2025
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ASCs deliver lower costs but face uphill payment, regulatory challenges

Editor's Note Ambulatory surgery centers (ASCs) continue to offer significant cost savings over hospital outpatient departments (HOPDs), but payment inequities, regulatory constraints, and growing competitive pressures are straining operations and growth prospects. Recent data show wide cost differentials between settings, Becker’s ASC Review June 20 reports. A Blue Health Intelligence…

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By: Tarsilla Moura
June 25, 2025
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Robotic shoulder surgery enters ASCs, paving way for broader adoption

Editor's Note Surgeons are performing robotic shoulder replacements in ambulatory surgery centers (ASCs) for the first time, signaling a significant shift in the trajectory of outpatient total joint arthroplasty. According to Outpatient Surgery Magazine May 7, the world’s first robotic total shoulder replacement outside of a hospital took place on…

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By: Tarsilla Moura
June 17, 2025
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Colonoscopy follow-up safe after 75: Study finds age alone shouldn’t guide decisions

Editor's Note Routine colonoscopy surveillance after polyp removal is safe for adults over 75 and should not be ruled out based on age alone, according to a new study from Kaiser Permanente published on May 27 in Clinical Gastroenterology and Hepatology. The research, conducted as part of the National Cancer…

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By: Tarsilla Moura
June 3, 2025
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