Translating MIPS Value Pathways into perioperative practice—What OR leaders need to know
In July 2025, the Centers for Medicare & Medicaid Services (CMS) proposed sweeping changes to the Medicare Physician Fee Schedule for calendar year 2026. Among the most impactful updates is the launch of the Ambulatory Specialty Model (ASM)—a mandatory value-based payment program focused on heart failure and low back pain.…
Providers call for deeper reform despite CMS proposing payment hikes in 2026
Editor's Note CMS is boosting 2026 Medicare outpatient payments by 2.4%, but provider groups warn the increase barely scratches the surface of mounting financial strain. Alongside the payment bump, the agency is proposing a two-track physician reimbursement model that ties rates to value-based care participation. While some see these moves…
CMS 2026 proposed rule: Expanded ASC access, higher payments, tighter quality reporting
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…
High drug manufacturing costs threaten hospital-led pharmacy expansion
Editor's Note Hospitals are ramping up in-house pharmacy operations to boost revenue and improve care, but high US manufacturing costs continue to stall a broader federal effort to reshore drug production, Modern Healthcare June 5 reports. As detailed in the article, an aging, medically complex population is driving demand for…
Healthcare leaders project revenue gains from value-based care despite persistent hurdles
Editor's Note Nearly two-thirds of healthcare organizations expect increased revenue from value-based care (VBC) arrangements in 2024, signaling growing confidence in the model despite concerns over financial risk and infrastructure gaps, according to a May 19 report in Healthcare Finance. The findings are based on a nationwide survey of 168…
Report: Hospitals double down on ASCs as outpatient shift accelerates
Editor's Note Hospitals and health systems are all-in on ambulatory surgery centers (ASCs), with ownership now the rule rather than the exception, according to the 6th Avanza Intelligence Hospital Leadership ASC Survey published in 2025. The report, produced in partnership with HealthLeaders Media, shows 82% of hospitals now own at…
AI reshapes healthcare leadership
Editor's Note Chief data officer (CDO) is a fast-growing C-suite role across the economy, with the notable exception of healthcare. The reasons why might be surprising: these roles have already been filled. Rather than growing, they are evolving. That’s the primary message of a March 4 report in Becker’s Hospital…
Study: CMS sepsis care protocol shows no clear mortality benefit
Editor's Note A systematic review found no strong evidence that compliance with the CMS Severe Sepsis and Septic Shock Management Bundle (SEP-1) reduces mortality, raising questions about its inclusion in hospital performance measures, according to a February 19 report from the University of Minnesota’s Center for Infectious Disease Research and…
Opening Keynote: Charting Your Course to Success—Financial Wins through Value-Based Performance
Editor's Note Although the central tenets of value-based healthcare have not changed, in many cases implementation has been reduced to little more than reducing costs, to the detriment of clinicians and patients. In a session at the 2025 OR Business Management Conference in February, economist Susanna Gallani, PhD, examined this…
Healing healthcare: How clinician incentives can help get from volume to value
Takeaways • Although the central tenets of value-based healthcare have not changed, in many cases implementation has been reduced to little more than reducing costs, to the detriment of clinicians and patients. • The right incentives, such as recognition and work support, can effectively inspire clinicians to deliver high value…
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