CMS issues call to action to healthcare providers aimed at limiting spread of COVID-19
Editor's Note In a March 4 press release, the Centers for Medicare & Medicaid Services (CMS) called on all healthcare providers to make sure they are implementing infection control practices, which they are required to maintain at all times, in an effort to limit the spread of the Novel Coronavirus…
Effect of total joint bundled payment program on patient selection
Editor's Note In this study, researchers found little to no significant change in the characteristics of patients having total hip and knee replacement surgery after the Centers for Medicare & Medicaid Services introduced the mandatory bundled payment programs in selected metropolitan statistical areas. The analysis included a matched set of…
CMS proposes changes to total joint bundled payment program
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on February 20 issued a rule proposing changes to the Comprehensive Care for Joint Replacement (CJR) program, which bundles payments to acute care hospitals for hip and knee replacement surgical procedures. CMS proposes extending the CJR model for an additional…
Study challenges concerns about HRRP
Editor's Note This study from the division of cardiology at Dallas’ University of Texas Southwestern Medical Center and the Yale School of Medicine, New Haven, Connecticut, challenges concerns about Medicare’s Hospital Readmission Reduction Program (HRRP)--ie, that it leaves patients more vulnerable and increases postdischarge mortality rates. Analyzing inpatient and outpatient…
CMS expects greater scrutiny from Joint Commission surveyors
[This article from the January 2020 issue of OR Manager summarizes information presented at the 2019 OR Manager Conference. The presenter offered tips to help attendees comply with Joint Commission standards and achieve a successful Joint Commission survey. Readers are asked to note the following points of clarification: The presentation…
To avoid penalties, know the rules for quality reporting
Keeping up with Medicare’s regulatory and reporting requirements for ambulatory surgery centers (ASCs) can be as difficult as ensuring physicians arrive to start their cases on time. “Regulations can change frequently,” says Gina Throneberry, MBA, RN, CASC, CNOR, director of education and clinical affairs for the Ambulatory Surgery Center Association…
Hospital-based care coordination strategies linked to CMS star ratings
Editor's Note Care coordination strategies were found to be associated with high overall hospital quality star ratings from the Centers for Medicare & Medicaid Services (CMS) in this study. A total of 710 general acute care noncritical access hospitals that received star ratings and responded to the 2015 American Hospital…
A primer for starting a total joint replacement program
Ambulatory surgery centers (ASCs) have increasing incentives to offer total joint replacements (TJR) as Medicare expands the list of covered procedures. However, there’s a lot to consider in this particular service line. “There are many things to arrange that aren’t required with other service lines, particularly as home care of…
Improving prediction of adverse surgical outcomes with machine learning algorithm
Editor's Note In this study, a new machine learning Complexity Score algorithm outperformed three commonly used risk scores in predicting postoperative morbidity, 30-day readmission, 90-day readmission, and postoperative surper-use. Study patients underwent colectomy, abdominal aortic aneurysm repair, coronary artery bypass grafting, total hip or knee replacement, or lung resection. The…
CMS releases 2020 final payment rule for ASCs, HOPDs
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on November 1 released its final payment rule for ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs). CMS added eight codes to the ASC-payable list, including total knee arthroplasty. CMS also removed total hip arthroplasty and seven spine codes from…
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