Costs & Cost Controls

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January 2025
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Low-cost, high-volume services account for most of unnecessary healthcare spending

Editor's Note Low-cost, high-volume healthcare services account for a high percentage of unnecessary spending, adding strain to the healthcare system, this study finds. In this analysis of 5.5 million patients in Virginia, researchers found that services providing no net health benefits cost the state’s healthcare system more than $586 million…

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By: Judy Mathias
October 12, 2017
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Factors linked to readmission after total hip

Editor's Note All-cause readmission is the only metric in widespread use, but it overlooks important information that enables readmission risk to be understood, this study finds. Of 514,455 patients in the UK analyzed over a 10-year period, there were 30,489 all-cause readmissions, 16,499 readmissions related to the surgical site, and…

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By: Judy Mathias
October 5, 2017
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ECRI Institute's new SERVICEguide helps reduce costs of outsourced services

Editor's Note SERVICEguide is the ECRI Institute’s new membership-based advisory service that helps hospitals maintain and manage their outsourced services. SERVICEguide includes an interactive assessment dashboard with spend analytics that reveal the highest potential areas for savings. Recently, for example, ECRI Institute helped a large healthcare system save more than…

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By: Judy Mathias
September 25, 2017
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Editorial

Since July, when repeal and replacement of the Affordable Care Act (ACA) stalled, healthcare reform has been somewhat overshadowed by events such as natural disasters and concerns about national security. Now, with insurers due to announce rates for the coming year, Congress is working on a bill to stabilize the…

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By: Elizabeth Wood
September 20, 2017
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Price transparency tool did not reduce spending for California public employees, retirees

Editor's Note Offering a price transparency tool to California public employees and retirees that focused on services such as lab tests, office visits, and advanced imaging services did not lower spending, this study finds. Only 12% of employees used it in the first 15 months after it was introduced, and…

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By: Judy Mathias
September 5, 2017
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California county goes surgery shopping

Editor's Note California's Santa Barbara County and other government employers are joining private employers in shopping for lower-cost bundled surgical care, even if it means going out of town, the September 1 Kaiser Health News reports. The voluntary program that includes incentives such as waived copays and deductibles as well…

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By: Judy Mathias
September 5, 2017
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Costs vary widely for common surgical procedures

Editor's Note There is wide cost variation for five common surgical procedures in the US, this study finds. Cost observed-to-expected ratios ranged widely: 14.9-fold for colectomy 5.5-fold for coronary artery bypass graft (CABG) 12.5-fold for lung resection 10.6-fold for total knee arthroplasty 28.0-fold for cesarean section. High-cost hospitals were more…

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By: Judy Mathias
August 30, 2017
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Payment variation in CABG episodes of care can affect bundled payments

Editor's Note Wide variation was found in 90-day coronary artery bypass grafting (CABG) episode payments for Medicare and private payer patients in this study. The differences were driven by increased use of evaluation and management services, higher utilization of inpatient rehabilitation, and patients with multiple readmissions. In the analysis of…

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By: Judy Mathias
August 25, 2017
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Voluntary bundled-payment models shifting to outpatient procedures

Editor's Note Though the Centers for Medicare & Medicaid Services (CMS) is rolling back mandatory bundled-payment programs, it is expected to release more voluntary, outpatient-focused programs, which shifts power from hospitals to physicians, the August 21 Healthcare Finance News reports. Physician-focused does not require a hospitalization, which creates a complete…

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By: Judy Mathias
August 24, 2017
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Obese cardiac surgery patients use more ICU resources

Editor's Note After cardiac surgery, obese patients required significantly more ICU resources and longer recovery times, resulting in more expensive, labor-intensive care, this study finds. Of 5,365 patients included in the analysis, 1,948 were classified as obese. Patients with greater obesity were: four times more likely to have longer time…

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By: Judy Mathias
August 10, 2017
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