Providers push back on insurance cost-cutting hurdles
Editor's Note Escalating administrative hurdles from insurers are heightening tensions between healthcare payers and providers who criticize the measures for threatening patient care, Modern Healthcare reported January 22. According to the article, policies attracting criticism include stringent prior authorization rules, claims denials, and new fees for appeals. For their part,…
Podcast episode discusses the anesthesia provider shortage in ASCs
Editor's Note In a January 9 episode of the Advancing Surgical Care Podcast, ASCA President Mark Wainner engaged Alfonso del Granado, MBA, FACHE, CASC, an ASCA Board member and administrator of Covenant High Plains Surgery Center in Lubbock, Texas, in a discussion focusing on the pressing issue of anesthesia provider…
Prosthetic insurance coverage disparities persist despite legal protections
Editor's Note Health insurance coverage of prosthetics remains inconsistent and often inadequate, KFF Health News reported January 6. As a result, many patients face coverage denials due to claims of lack of medical necessity or high costs despite significant advancements in prosthetic technology, such as microprocessor-controlled knees and myoelectric hands.…
Surgical legislation advocacy focuses on safety, access
“Surgeons are the only people trained to provide surgery—life-saving care," says Carrie Zlatos, chief of legislative and political affairs at the American College of Surgeons (ACS). "They are an essential element of a community-based healthcare system. Regardless of where you live, everyone should have access to full quality surgical care.”…
Orthopedic research showcases stem cells’ surgical promise
Stem cell therapy is poised to revolutionize regenerative medicine. As these therapies advance, they may alter or even replace certain invasive surgical procedures. Already undergoing advanced clinical trials, orthopedic applications are likely candidates for attracting the earliest adopters. Results so far indicate significant potential for providing alternatives to implants, grafts,…
Costs drop, access expands for GLP-1 weight loss drugs
Editor's Note Access to GLP-1 medications is improving as manufacturers, insurers, and policymakers address high demand, costs, and coverage challenges, Becker’s Hospital Review reported December 13. As detailed in the article, Eli Lilly’s partnership with telehealth company Ro now allows patients to obtain Zepbound prescriptions online and receive shipments directly…
Anthem anesthesia payment policy reversal prompts statement from American Society of Anesthesiologists
Editor's Note The American Society of Anesthesiologists (ASA) commended Anthem's reversal of a policy to deny anesthesia payment based on arbitrary time limits, which was set for February 2025 in three states. “The now-rescinded policy was inconsistent with prevailing standards, regulations and billing norms, and revealed a diminished dedication to…
AHA's Congressional "wish list" calls for financial relief, patient access, workforce protections
Editor's Note In a November 12 letter to Congress, the American Hospital Association (AHA) outlined its priorities for the lame-duck legislative session, focusing on measures to stabilize hospitals and health systems facing significant financial and operational pressures. If enacted, these recommendations would support the nation’s healthcare infrastructure amid rising…
Trump vs. Harris: Key differences in healthcare proposals for Medicaid, Medicare, private insurance, abortion
Editor's Note When it comes to the 2024 presidential election, “Neither candidate addresses a return to the fundamental tenet of healthcare: the patient-physician relationship,” reads the closing line of an “election guide” from Richard Menger MD MPA. In the preceding paragraph, Menger also argues that both candidates also neglect issues…
Medicare Advantage insurers prioritize profits over patients, Senate reports
Editor's Note A Senate report reveals that Medicare Advantage insurers are increasingly prioritizing profits over patient care by ramping up the use of prior authorization to deny necessary services, particularly post-acute care, for older adults, Becker’s Hospital Review reported October 17. In May 2023, the Senate Permanent Subcommittee on Investigations…
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- Study: ERAS protocol reduces opioid use after cardiac surgery
- Study: Prehabilitation reduces surgical complications, speeds recovery
- Commentary: Studies show how surgeon decisions follow the money
- Proposed HIPAA updates would improve cybersecurity, increase costs for healthcare providers
- Study: EMR data can enhance hand hygiene compliance, infection prevention
- Study: Machine learning model improves perioperative pain assessment
- Call for improved suicide risk screening in ASCs aims to strengthen safety protocols
- Study: Perioperative pregabalin reduces risk of kidney decline compared to gabapentin
- Medical school diversity declines after Supreme Court ruling
- Surgeons risk losing ground as transcatheter tricuspid valve interventions rise