Tag: Reimbursement

COVID-19 vaccine mandate for HCWs blocked in 10 states

Editor's Note A federal judge, on November 29, blocked a Centers for Medicare & Medicaid Services (CMS) mandate requiring COVID-19 vaccinations for healthcare workers (HCWs) in facilities participating in CMS programs in 10 states, the November 29 Bloomberg Law reports. In his ruling, the judge says the CMS mandate requires…

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By: Judy Mathias
November 30, 2021
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New value-based models allow for surgeon buy-in, cost savings

The growth of value-based healthcare models is changing the way physicians and hospitals provide care. In value-based models, providers are paid based on patient outcomes. The “value” is derived from measuring health outcomes against the cost of delivering the outcomes. This balancing act has now become more achievable with new…

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By: Judith M. Mathias, MA, RN
November 17, 2021
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Cleveland Clinic mandates COVID-19 vaccinations for US employees

Editor's Note Cleveland Clinic, on November 12, announced that it is requiring all US employees and those who provide services with Cleveland Clinic to receive the COVID-19 vaccine by January 4, 2022. In accordance with federal mandates from the Centers for Medicare & Medicaid Services, employees who are not fully…

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By: Judy Mathias
November 15, 2021
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CMS releases final Medicare payment rule for ASCs, HOPDs

Editor's Note The Centers for Medicare and Medicaid Services (CMS), on November 2, released its 2022 final payment rule for ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs). The final rule increases Medicare prospective payment system rates by a net 2.0%—a combination of a 2.7% inflation update based on…

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By: Judy Mathias
November 3, 2021
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CMS penalizes nearly half of all hospitals for high readmission rates

Editor's Note In FY 2022, the Centers for Medicare and Medicaid Services (CMS) will penalize 2,499 (47%) hospitals for excessive patient readmissions, the October 28 Kaiser Health News reports. In its 10th year of the Hospital Readmissions Reduction Program, CMS will cut payments to the penalized hospitals by as much…

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By: Judy Mathias
November 1, 2021
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How might telehealth alter approaches to surgical patient care?

Telehealth services grew exponentially in the early days of the COVID-19 pandemic. Overall telehealth utilization for office visits and outpatient care was 78 times higher in April 2020 than in February 2020, according to a McKinsey & Company July 2021 report. Since then, telehealth utilization has stabilized at levels that…

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By: Elizabeth Wood
September 21, 2021
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Act now to address predicted gaps in anesthesiology coverage

Perioperative services leaders have their hands full with a range of pressing issues, from the return of elective case cancellations to new struggles with staff turnover. However, an even bigger problem is flying under the radar for many hospitals—impending changes in the market for anesthesiology services. Several factors are coming…

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By: Joshua Miller, MD, Thomas Blasco, MD, MS and Kartik Bhatt, MPH
September 21, 2021
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Widening of racial, socioeconomic healthcare gap for organ transplant patients during COVID-19

Editor's Note This study led by researchers at the University of Texas Southwestern Medical Center, Dallas, finds that although COVID-19’s effect on access to liver transplantation has been all-pervasive, minorities have been disproportionately affected—especially those with public insurance. During the initial wave of COVID-19, organ transplantation was classified as a…

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By: Judy Mathias
September 16, 2021
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Maintaining a productive OR as cases shift to ASCs

The migration of surgical procedures from hospital ORs to hospital-owned ambulatory surgery centers (ASCs) is picking up speed. According to a recent survey, three-quarters of larger hospitals now have an ownership stake in more than one ASC. Two-thirds of US health systems are currently planning to increase their ASC investment.…

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By: Leslie Basham, MBA, Thomas Blasco, MD, MS, Brian Watha, MHSA, Anne Cole, RN, MSN, CNOR and Joan Dentler
August 19, 2021
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Medicaid expansion reduces uninsured surgical hospitalizations, financial burden

Editor's Note This study from Duke University Medical Center, Durham, North Carolina, finds that Medicaid expansion was associated with a reduction in uninsured surgical hospitalizations. Researchers analyzed state-level data across 44 states and patient-level data across four states, and they compared hospitalizations in expansion and non-expansion states. Uninsured surgery patients…

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By: Judy Mathias
August 5, 2021
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