Editor's Note The widely used “LACE index,” which assesses a patient’s risk of hospital readmission, has a “blindspot” because it fails to consider whether patients are on Medicaid, West Virginia University researchers say. LACE stands for length of stay, acuity, comorbidity, and emergency department. To assess the predictive value of…

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Postoperative pain management has always been a major focus of patient care. However, the opioid crisis is increasing the challenges healthcare leaders face because of the call for a national change in modalities of pain management. Regulatory bodies, specifically, are executing control to confront the opioid epidemic head on, making…

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The holiday spirit got off to a good start at ambulatory surgery centers (ASCs) across the country with the November 2, 2018, announcement of the Centers for Medicare & Medicaid Services’ (CMS) 2019 Ambulatory Surgical Center Payment System and Quality Reporting (ASCQR) Program Final Rule. Several significant changes ASCs had…

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Editor's Note Medicare’s Hospital Readmissions Reduction Program (HRRP), which penalizes readmissions for several targeted conditions, has been credited with lowering readmission rates; however, these reductions now appear to be overstated, this study finds. A concurrent change in electronic transaction standards that increased diagnostic coding allowed hospitals to document a larger…

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Editor's Note The Centers for Medicare & Medicaid Services (CMS) underpaid hospitals by $76.8 billion in 2017, according to data from the American Hospital Association’s Annual Survey of Hospitals. Medicare underpayments totaled $53.9 billion, and Medicaid underpayments were $22.9 billion. Hospitals also provided $38.4 billion in uncompensated care, the January…

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Editor's Note In the first 2 years of Medicare’s Comprehensive Care for Joint Replacement (CJR) program, there was a modest reduction in spending per procedure without an increase in complication rates, this study finds. Comparing costs associated with 280,161 joint replacement procedures in 803 hospitals required to participate in the…

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Editor's Note Participation in the Comprehensive Care for Joint Replacement (CJR) bundled payment program was associated with changes in care delivery and compensation practices, this study finds. This survey of 73 orthopedic surgeons found that those practicing in CJR hospitals were more likely to report their hospitals had implemented programs…

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Editor's Note The Centers for Medicare & Medicaid Services announced December 3 that more than 1,550 hospitals will share $1.9 billion in bonus payments under the Hospital Value-Based Purchasing Program for FY 2019. Though it is a slight decline from FY 2018, average performance scores were higher at 38.1%, compared…

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Editor's Note The Centers for Medicare & Medicaid Services (CMS) on November 27 launched a new online tool that compares Medicare payments and co-payments for certain outpatient surgical procedures performed in hospitals and ambulatory surgery centers. The “Procedure Price Lookup” tool will help Medicare patients consider potential cost differences when…

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Editor's Note The Centers for Medicare & Medicaid Services should measure surgeon spending at a group level or incorporate multiple years of data to reduce misclassification of surgeon performance in its Merit-based Incentive Payment System (MIPS) program, this study finds. University of Michigan researchers found that annual cost-profiles of individual…

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