Costs & Cost Controls Editor's Note Septicemia was the most expensive condition treated in US hospitals in 2013, according to the Agency for Healthcare Research and Quality. Others in the top 20 most expensive were: osteoarthritis, 2nd complications of device, implant, or graft, 4th complications of surgical procedures or medical care, 13th hip fracture,…
Editor's Note In this study from Johns Hopkins, Baltimore, payments for colectomy under Medicare’s Bundled Payments for Care Improvement Initiative were lower than a fee-for-service payment model, and the proportion of patients contributing to a net negative margin increased. Net negative margins were calculated as the difference between total hospital…
Type 1 natural rubber latex allergic reactions are avoidable in the OR. Typically, surgical gloves are the last products remaining in the OR that contain natural rubber latex (NRL). Higher-cost, clinically acceptable synthetic latex surgical gloves are readily available. However, OR leaders can encounter significant resistance from hospital administrators when…
Editor's Note Through its Value Based Purchasing (VBP) program, the Centers for Medicare and Medicaid Services (CMS) paid bonuses to 231 hospitals with lower quality because their patients were less expensive, this study finds. CMS began measuring both spending and quality in FY 2015 to encourage hospitals to provide more…
Surgeon champions can make or break a perioperative initiative. But it’s not enough to simply identify a single champion. OR leaders must engage a wide range of physicians to improve the organizational structure of the healthcare system. At Intermountain Healthcare, a 22-hospital system based in Salt Lake City, Utah, surgical…
Editor's Note A new analysis by Avalere Health (Washington, DC) finds that 60% of hospitals participating in Medicare’s Comprehensive Care for Joint Replacement bundled-payment model could face penalties if they don’t reduce their costs. The average total joint costs around $13,000, but the entire episode-of-care costs twice that at $26,000.…
Editor's Note Most Americans do not think healthcare prices and quality are associated and may avoid low-price care, finds this study. Depending on how the question was framed, 58% to 71% of Americans in a nationally representative survey did not associate healthcare prices and quality. A minority did perceive an…
Editor's Note Patients undergoing minimally invasive mitral valve repair or replacement (mini-MVR) have similar outcomes as patients having traditional open procedures and also experience shorter hospital stays and fewer blood transfusions, finds this study. The study included 1,304 patients, including 425 mini-MVRs. Compared with traditional MVR, Mini-MVR patients had similar…
Editor's Note Use of an Enhanced Recovery after Surgery (ERAS) program in total hip and total knee patients reduced length of stay by 1 day in this study. Short term complications and readmission rates were similar for patients in the ERAS program and those managed in a traditional perioperative care…
Editor's Note Over the next 10 years, the Affordable Care Act (ACA) will cost $1.34 trillion, which is $136 billion more than the Congressional Budget Office predicted a year ago, the San Francisco Chronicle reports. The hike in costs is mostly a result of higher-than-expected enrollment in the expanded Medicaid…
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