Coordinating surgical care means precise staff handoffs
In every OR, the complicated dance of surgical care coordination—the series of handoffs between stakeholders throughout the surgery lifecycle—is performed mainly in the background. Those stakeholders include physician offices, schedulers, preadmission testing, insurance verification, vendors, sterile processing, supply chain, anesthesia, and surgical staff. But what does it look like when…
Colonoscopy fees higher for hospitals than ASCs, study finds
Editor’s Note US hospitals charge approximately 55% higher average fees than ambulatory surgical centers (ASCs) for colonoscopies covered by private health insurance. The findings, from the Johns Hopkins Bloomberg School of Public Health, appeared as a research letter in JAMA Health Forum on December 15. The analysis is one of…
Doctors with multiple malpractice suits become insurance company medical directors
Editor’s Note An investigation by the nonprofit organization ProPublica and the Capital Forum revealed many doctors with a history of malpractice cases now serve as insurance company medical directors—a role with major influence on decisions that impact patient outcomes. According to a December 15 article in ProPublica, the organizations used…
Proposed bill seeks to end costly insurance fees on electronic healthcare payments
Editor's Note A new bill introduced by a bipartisan group in Congress seeks to ban fees on electronic healthcare payments from insurance companies, which cost hospitals millions and are a particular burden on hospitals in rural areas, according to a November 28 press release. The bill is called the No…
Healthcare costs making Americans poorer, sicker
Editor's Note The high cost of healthcare is leading many Americans to skip care and forgo medications, according to the 2023 Healthcare Affordability Survey by the Commonwealth Fund published on October 26. Some highlights of the survey include: A large number of insured working-age adults surveyed admitted difficulty affording their…
A closer look at variations in regional health insurance prices
Editor's Note This new study in JAMA Health Forum is one of the first to review publicly available insurer price data and compare regional rate differences. The research was published by JAMA Network on October 27. Following are some highlights: Over half of the US population receives health insurance from…
New agreement between HHS, Pfizer to ensure access to Paxlovid
Editor's Note The US Department of Health and Human Services (HHS) and Pfizer have announced an agreement to extend patient access to the COVID-19 drug Paxlovid, Healthcare Purchasing News October 16 reports. According to the article, Pfizer is readying the drug for more availability in the commercial market in November…
Problems with prior authorization, utilizing health insurance coverage are prevalent, survey finds
Editor's Note This KFF survey from June 2023 found that some six in 10 adults with health insurance have experienced problems when trying to use their insurance, KFF Health News September 29 reports. The problems included denied claims, network adequacy issues, and preauthorization delays and denials. According to the survey,…
Effect of unmet social health needs on surgical outcomes
Editor's Note This study, led by researchers at the University of Michigan, Ann Arbor, examines opportunities to improve inequitable postoperative outcomes by evaluating unmet social health needs by race, ethnicity, and insurance type. Outcomes included poor health status (self-reported), socioeconomic status (income, education, employment), and unmet social health needs (food,…
Price transparency in surgical settings
Takeaways • Healthcare consumers are not aware that they can ask how much something costs. • There is disconnect between the law and common knowledge, and patients generally are confused about what they receive as good faith estimates. • In addition to incorrect CPT codes and OON allowable charges, the…
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