Physician alignment is a key element of current hospital strategy. Last month, we looked at how hospital ORs can use co-management agreements to build strong collaboration with surgeons. Payment reform has created an even more sophisticated option—participation in a bundled payment program. Bundled payment initiatives are more complex than most…
Medicare administrative contractors (MACs) in several states recently ratcheted up their documentation requirements for joint replacement surgery and other orthopedic procedures. For hospital ORs, these changes represent the tip of an iceberg that calls for careful navigation. Enhanced medical necessity documentation requirements were launched in Florida in 2011. The state’s…
Leaders of ambulatory surgery centers (ASCs) can expect to continue facing challenges related to reimbursement even as they try to increase the kinds of procedures that can be performed in their facilities, say experts with the Ambulatory Surgery Center Association (ASCA). Other key factors that will determine their future success…
The Centers for Medicare & Medicaid Services (CMS) on April 30 issued its proposed rule that would update FY 2015 Medicare payment polices and rates for inpatient stays at general acute care and long-term care hospitals. The proposed rule will increase the payment rate to general acute care hospitals by…
Anxiety over changes in healthcare delivery and payment systems has permeated hospitals and ambulatory surgery centers (ASCs). Administrators are concerned about how the Affordable Care Act (ACA) and other initiatives will hit the organization’s bottom line. Increasingly, perioperative services leaders are being drawn into discussions in these areas. “The OR…
With the expansion of Medicare readmission penalties to elective total-knee and total-hip arthroplasty patients in 2014 comes an increasing demand for OR leaders to ensure better postdischarge care. To avoid readmissions, OR management will have to be more proactive about reducing length of stay and complications and providing for care…
The Patient Protection and Affordable Care Act (ACA) is affecting every part of the healthcare system, including ambulatory surgery centers (ASCs). Whether it will help or hinder ASCs, however, will depend on how adept they are at managing changes in the way they are paid and how they interact with…
OR Business Performance is a series intended to help OR managers and directors improve the success of their business. Data-rich dashboards are an effective way to communicate with surgeons and align them with OR goals, but many reporting strategies have not kept pace with changes in the surgery market.…
It sounds like déjà vu all over again, as Yogi Berra used to say. That is likely to be the first reaction of many ambulatory surgery center (ASC) administrators to the Calendar Year 2014 Ambulatory Surgical Center Payment Proposed Rule. Pay formula unchanged Medicare payment updates would continue at…
The Ambulatory Surgery Center Association (ASCA) annually asks members to participate in a “fly-in” to meet with members of Congress to raise awareness about the implications of health care policies. As ASCA vice president of government relations Steve Miller notes, there is nothing like hearing directly from a constituent to…