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January 2025
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Reimbursement denials diminish with more precise precertification

With no increases in reimbursement on the healthcare horizon, the leadership team at Advocate Good Samaritan Hospital in Downers Grove, Illinois, knew they needed to maximize revenue capture. The team, including Katrina Spears, MAOL, manager of business and informatics, used Lean methodology to improve precertification and reduce denials, resulting in…

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By: OR Manager
January 18, 2017
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Adding new business to the ASC, one procedure at a time—Part 1

An ambulatory surgery center (ASC) looking to expand its market may want to add new procedures, but only after careful consideration of resource investment versus ultimate benefit. In the first of a three-part series, OR Manager explores surgical specialties that appear to show promise for the outpatient setting. One of…

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By: Paula DeJohn
January 18, 2017
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Care after surgery drives costs

Editor's Note This study finds that where surgical patients go after they are discharged varies widely, and that variation leads to huge differences in how much their care costs. Variation in postacute care spending between lowest and highest quintiles differed 129% for total hip replacement, 103% for coronary artery bypass…

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By: Judy Mathias
January 11, 2017
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Colorectal SSIs plummet with evidence-based care bundles

Surgical site infections (SSIs) not only harm patients, but also can squeeze a hospital’s bottom line through increased costs and reduced reimbursement. Patients undergoing colorectal surgery are particularly at risk for SSIs, according to data from the National Healthcare Safety Network (NHSN), but an effective multidisciplinary team and an evidence-based…

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By: OR Manager
December 14, 2016
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Surgical receipt raises quality standards, lowers costs

Increasing costs and shrinking margins have continued to pressure business managers and senior hospital leadership to rethink strategies for raising surgeons’ awareness of product and nonlabor costs within the OR. Often providers are asked to cut costs but are unaware of the actual costs of the products they use. In…

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By: OR Manager
December 14, 2016
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Huddles help hospitals move toward the goal

Like a football team gathering to confirm tactical details before a play, surgical staff often form a huddle to ensure readiness of the providers, patient, and equipment for the upcoming procedure. In a twist on the traditional huddle the day before surgery, staff at the Hospital of Central Connecticut (HOCC)…

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By: OR Manager
December 14, 2016
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Surgeon scorecard linked to surgical supply costs

Editor's Note Giving monthly cost feedback scorecards to surgeons was associated with significantly reduced surgical supply costs, without negatively affecting patient outcomes in this study. Of 249 surgeons representing 10 specialties, 63 were in the intervention group and 186 were in the control group. Surgeons in the intervention group each…

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By: Judy Mathias
December 12, 2016
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Variation in hospital and surgeon payments for general vs orthopedic procedures

Editor's Note Hospital and surgeon payments for routine general and orthopedic surgical procedures vary greatly, this study finds. Hospital payments averaged $12,744 for general surgery procedures and $22,386 for orthopedic procedures. Orthopedic surgeon reimbursement on average was twice as high as general surgeon payments ($2,349 vs $1,191). Postoperative complications resulted…

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By: Judy Mathias
December 2, 2016
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Factors associated with postop readmission to nonindex hospital

Editor's Note Patients who were readmitted to a nonindex hospital after having emergency general surgery were significantly more likely to have had their index surgery at a large, teaching, safety-net hospital, this study from Brigham and Women’s Hospital, Boston, finds. Readmission to a nonindex hospital was independently associated with mortality…

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By: Judy Mathias
November 17, 2016
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CMS releases final rule on OPPS/ASC rates

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on November 1 released a final rule that revises the hospital outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) payment system for CY 2017. According to the rule, hospital off-campus facilities will no longer be paid the same…

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By: Judy Mathias
November 2, 2016
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