Tag: Reimbursement

Comprehensive dashboards paint a fuller picture of OR performance

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.…

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By: OR Manager
October 1, 2013
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New quality measures, tight deadline mark CMS payment rule for ASCs

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…

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By: OR Manager
October 1, 2013
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ASC executives to meet with lawmakers

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…

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By: OR Manager
August 1, 2013
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Can your OR documentation stand up to a RAC audit?

A column on managing the OR revenue cycle. Audits of Medicare payments to hospitals are up dramatically. In all, 89% of hospitals reported activity by recovery audit contractors (RACs) in the third quarter of 2012, according to an American Hospital Association (AHA) survey. Here are tips on how your OR…

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By: OR Manager
July 1, 2013
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Pain and patient experience: A business partnership

Managing patients’ pain is no longer just a clinical goal—it’s a business necessity. The Centers for Medicare and Medicaid Services (CMS) has started incorporating value-based purchasing (VBP) scores, which include customer satisfaction, into hospital reimbursement payments. Of the total VBP score, 30% comes from results from the Hospital Consumer Assessment…

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By: OR Manager
June 1, 2013
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Surgery is front and center in new Medicare value-based purchasing

This year, the quality movement takes a big step with the start of Medicare’s value-based purchasing (VBP) program. Beginning October 1, 2012, part of your hospital’s Medicare payments will be based on your hospital’s performance on a set of quality measures, usually referred to as the core measures and HCAHPS…

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By: OR Manager
January 31, 2012
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Hospitals losing on physician preference items

An analysis by Premier of data from 323 of its member hospitals shows they are losing $1.82 billion annually for 12 orthopedic and cardiac case categories because of Medicare reimbursement shortfalls. Lack of evidence-based outcomes data and the rising cost of physician preference items (PPIs) are also cited as reasons…

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By: OR Manager
January 25, 2012
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Value-based purchasing rule is final

July 1, 2011, marks the start of hospitals' first performance period under Medicare's new value-based purchasing program. The initial performance period runs through March 31, 2012. The final rule was released April 29, 2011, for the program, which covers hospitals under the inpatient prospective payment system, with some exceptions. Value-based…

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By: OR Manager
June 1, 2011
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HCAHPS: How the OR's scores affect your whole organization

Fiscal year 2013 will be a milestone for hospital reimbursement. That's the year Medicare's proposed new hospital value-based purchasing program starts. Under value-based purchasing, a portion of hospitals' DRG reimbursement will be based on their performance on quality metrics, including patient perceptions of the quality of care (PPQC). (See March…

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By: OR Manager
April 1, 2011
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90-day guarantee: Warranties as a tool for improved patient outcomes

Everything from washers to cars comes with a warranty, so why not health care? Geisinger Health System in Danville, Pennsylvania, introduced health care warranties with an innovative program called ProvenCare. Under the 90-day warranty, one cost covers the surgery and 90 days of follow-up treatment. Geisinger absorbs any additional costs…

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By: Cynthia Saver, RN, MS
July 1, 2009
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