Costs & Cost Controls

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January 2025
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ACS: 19 surgical organizations oppose CMS code G2211

Editor's Note The American College of Surgeons (ACS) announced, on July 26, that it and 18 other surgical organizations sent a letter to the Centers for Medicare & Medicaid Services (CMS), strongly opposing implementation of its code G2211. The G2211 code is an effort by CMS to pay more for…

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By: Judy Mathias
July 26, 2023
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Price transparency in surgical settings

Takeaways • Healthcare consumers are not aware that they can ask how much something costs. • There is disconnect between the law and common knowledge, and patients generally are confused about what they receive as good faith estimates. • In addition to incorrect CPT codes and OON allowable charges, the…

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By: Uyen Vo, BSN, MBA
July 20, 2023
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CMS proposes changes to price transparency rules, mental health services

Editor's Note On July 13, the Centers for Medicare & Medicaid Services (CMS) issued a proposal that would increase Medicare hospital outpatient prospective payment system rates by a net 2.8% in 2024 compared to 2023, including a “proposed 3% market basket update, offset by a 0.2% cut for productivity,” the…

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By: Tarsilla Moura
July 14, 2023
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Effect of private insurer bundled payment program for total joints on outcomes

Editor's Note This multi-center study led by Humana Inc, Louisville, Kentucky, finds that a bundled payment program offered by a Medicare Advantage insurer for lower extremity joint replacements was associated with reduced spending without changes in quality. A total of 23,034 lower extremity joint replacement surgical episodes (6,355 bundled, 16,679…

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By: Judy Mathias
June 27, 2023
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Contract standardization for endo-mechanical supplies saves millions

Takeaways One of the lessons learned when it comes to data was to make sure you do it right the first time. A big drive for standardization was to leverage the distribution center to send excess inventory that some sites had to sites that needed them. Another drive was the…

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By: Judith M. Mathias, MA, BS, RN
June 21, 2023
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CMS: Healthcare spending to reach nearly $7.2 trillion by 2031

Editor's Note This study from the Centers for Medicare and Medicaid Services (CMS) Office of the Actuary (OACT) estimates that US healthcare spending will grow by 5.4% per year on average from 2022 to 2031, now that the COVID-19 public health emergency has ended. Rising from $4.4 to $7.17 trillion,…

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By: Judy Mathias
June 20, 2023
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Increases, decreases to periop travel nurse pay

Editor's Note As of June 1, there were 125,937 active RN travel jobs on the Vivian Health platform, a national healthcare hiring marketplace, the June 7 Becker’s Hospital Review reports. Perioperative specialties with the largest increases and decreases in average weekly travel nurse pay in May, compared to April, were:…

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By: Judy Mathias
June 7, 2023
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Value assessment of a trauma hybrid OR

Editor's Note This study from the University of Florida Health, Gainesville, examines the complications, cost-utility, and value of a dedicated trauma-endovascular hybrid OR. A total of 292 trauma patients, who underwent immediate operative intervention at a Level I trauma center (106 before construction of a hybrid OR and 186 after…

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By: Judy Mathias
May 26, 2023
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CMS updates enforcement process for hospital price transparency

Editor's Note The Centers for Medicare & Medicaid Services, on April 26, announced updates to the enforcement process for its hospital price transparency rule. CMS will now automatically impose a civil monetary penalty if hospitals do not submit a corrective action plan on time or complete it within 45 days.…

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By: Judy Mathias
April 27, 2023
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US pauses green card applications for foreign nurses

Editor's Note The US State Department will not accept any more applications for green cards for foreign nurses this year, and only applications that were submitted by June 2022 will be processed until the backlog eases, the April 24 Becker’s Clinical Leadership & Infection Control reports. Current green card processing…

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By: Judy Mathias
April 24, 2023
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