Editor's Note Though Medicare Accountable Care Organizations (ACOs) have had some success in reducing spending for medical care, they have not had similar success with surgical spending, this study finds. Of 341,675 patients at 427 ACO hospitals and 1,024,090 patients at 1,531 non-ACO hospitals analyzed, average baseline payments were similar…
Early in a new year, there’s a tendency to reflect on how past events might inform the future. The January issue of OR Manager looked at 2018 legislative changes and their potential impact on healthcare. In just the past few weeks, several legal and financial actions have already changed the…
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…
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…
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…
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…
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…
Editor's Note The Department of Health and Human Services (HHS) on November 28 issued a draft strategy to reduce administrative and regulatory burdens caused by electronic health records (EHRs) and health information technology (health IT). The draft “Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health…
Editor's Note Hospitals that successfully attested to "meaningful use" of electronic health records (EHRs) experienced a shorter patient length of stay (LOS) in this study. This analysis of patient data from California categorized hospitals into one of three categories−partial adoption of EHRs, full adoption of EHRs, and meaningful assimilation of…
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…