Costs & Cost Controls

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January 2025
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Visual management supports perioperative Lean efforts

Takeaways • Visual management (VM) tools support Lean efforts, leading to improved quality and efficiency. • VM boards provide an overview of processes, facilitate problem solving, and promote staff-manager collaboration. • Other VM tools such as color coding and customized instrument trays can help reduce errors and save money. Lean…

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By: Cynthia Saver, MS, RN
January 1, 2025
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Implications of 2024 surgical care trends for the year ahead

Perioperative leaders are entering a time of uncertainty after 2024 proved to be transformative for inpatient and outpatient surgical care. Last year saw important updates from The Joint Commission and the Centers for Medicare & Medicaid Services (CMS) that emphasized improvements alongside ongoing challenges in safety, workforce shortages, reimbursement, and…

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By: Tarsilla Moura
January 1, 2025
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Exclusive articles preview OR Business Management Conference sessions

Editor's Note Although the term “value-based care” dates back nearly two decades, payer reimbursement models too often seem more like volume-based care. In a presentation at the upcoming OR Business Management Conference, scheduled February 10-12 at the Saddlebrook Resort in Tampa, Florida, economist Susanna Gallani, PhD, will delve into how…

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By: Matt Danford
December 19, 2024
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Simple procedure or ‘surgery’? Questionable medical billing practices cause confusion

Editor's Note Certain medical bills reclassifying minor procedures as “surgery” are driving up costs and causing confusion among patients, KFF Health News December 13 reports. Cases such as a $414 charge for a splinter removal with tweezers and a $469 charge for freezing a skin tag highlight how CPT codes…

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By: Tarsilla Moura
December 18, 2024
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Antitrust guideline withdrawal could dampen M&A, boost uncertainty for provider joint ventures

Editor's Note In a move that could hinder provider-led joint ventures and increase regulatory uncertainty, the Federal Trade Commission (FTC) and the Justice Department have withdrawn antitrust guidance issued in 2000. Modern Healthcare reported the news on December 16. Passed in a 3-2 vote, the decision eliminates previously relied-upon safe…

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By: Matt Danford
December 18, 2024
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Fitch Ratings: Hospital credit outlook improves amid stabilizing margins

Editor's Note The credit outlook for the nonprofit hospital sector improved from “deteriorating” to “neutral” in Fitch Ratings’ 2025 report, the first revision in more than 2 years. Healthcare Dive reported the news December 11.  According to the outlet, Fitch attributes the shift to “steady improvement” in hospital operating margins,…

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By: Matt Danford
December 17, 2024
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US obesity rates decline for first time in a decade

Editor's Note An analysis of trends in body mass index (BMI) and obesity among US adults from 2013 to 2023 reveals a slight but significant decline in obesity prevalence in 2023, marking the first decrease after years of steady increases. The findings are detailed in a December 13 JAMA Health…

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By: Matt Danford
December 16, 2024
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Costs drop, access expands for GLP-1 weight loss drugs

Editor's Note Access to GLP-1 medications is improving as manufacturers, insurers, and policymakers address high demand, costs, and coverage challenges, Becker’s Hospital Review reported December 13. As detailed in the article, Eli Lilly’s partnership with telehealth company Ro now allows patients to obtain Zepbound prescriptions online and receive shipments directly…

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By: Matt Danford
December 13, 2024
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Anthem anesthesia payment policy reversal prompts statement from American Society of Anesthesiologists

Editor's Note The American Society of Anesthesiologists (ASA) commended Anthem's reversal of a policy to deny anesthesia payment based on arbitrary time limits, which was set for February 2025 in three states. “The now-rescinded policy was inconsistent with prevailing standards, regulations and billing norms, and revealed a diminished dedication to…

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By: Matt Danford
December 6, 2024
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Study: AI improves surgical case length predictions

Editor's Note A recent study developed and validated an artificial intelligence (AI) model leveraging natural language processing (NLP) and machine learning to significantly improve prediction accuracy for surgical case length. Published November 29 in the journal Surgery, the findings show promise for using AI as an alternative to current methods…

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By: Matt Danford
December 4, 2024
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