ASCs reduce cost of outpatient surgery by $38 billion per year
Editor's Note An analysis of US commercial health insurance claims found ambulatory surgery centers (ASCs) reduce the cost of outpatient surgery by more than $38 billion per year compared to hospital outpatient departments, the Ambulatory Surgery Center Association said in a June 14 report. The study, which included more than…
Cost-effectiveness of free colonoscopy for high-risk uninsured
Editor's Note Performing free colonoscopies for uninsured patients at high risk for colorectal cancer can identify cancers at an earlier stage and is cost neutral for a health system, this study finds. Of 682 uninsured patients screened, 9 cancers ( 1 stage 0, 3 stage I, 2 stage II, and…
Make it your business to grow a healthy bottom line
In this challenging healthcare environment, OR leaders have a fiscal responsibility to help hospitals meet financial goals that contribute to a healthy bottom line. There is no more expensive procedure you can have in the hospital than to spend time in the OR,” says Keith Siddel, PhDc, JD, MBA, CHC.…
ACA costs rising
Editor's Note Over the next 10 years, the Affordable Care Act (ACA) will cost $1.34 trillion, which is $136 billion more than the Congressional Budget Office predicted a year ago, the San Francisco Chronicle reports. The hike in costs is mostly a result of higher-than-expected enrollment in the expanded Medicaid…
Physician practices spend $15.4 billion annually on quality reporting
Editor's Note Physician practices each year spend 785 hours per physician to track and report quality measures for Medicare and private health insurers at a cost of more than $15.4 billion a year, this study finds. Eight in 10 physicians surveyed reported spending more effort on quality measures now than…
CMS proposes Medicare Advantage changes for 2017
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on February 19 announced proposed changes to the Medicare Advantage program for CY 2017, which would increase payment rates by a net 1.35%, the February 19 Modern Healthcare reports. When factoring in the risk coding tendencies, Medicare Advantage insurers’ revenue…
CMS, health insurers standardize quality measures
Editor's Note The Centers for Medicare & Medicaid Services (CMS) and major health insurance plans, in concert with physician groups and other stakeholders, on February 16 announced a new agreement to standardize measures of quality for physicians. The agreement outlines seven core measure sets to be used as a basis…
Patient cost-sharing, insurance plans linked to postop readmissions
Editor's Note Increased patient cost-sharing among privately insured, nonelderly patients was associated with lower odds of readmission after abdominal surgery in this study. A $1,284 increase in patient out-of-pocket payments during admission for surgery was associated with a 19% decrease in the odds of 7-day readmission and a 17% decrease…
ICD-10 debuts October 1
Editor's Note The healthcare industry transitioned to the ICD-10 system October 1, expanding procedure codes from 14,000 to 70,000 for providers and from 44,000 to 72,000 for hospitals. Medicare officials say they won’t deny claims to providers solely for lack of specificity for the first 12 months, but that doesn’t…
Aetna to buy Humana for $37 Billion
Editor's Note Aetna Inc has agreed to buy rival health insurer Humana Inc for $37 billion in cash and stock, creating the second-largest provider of health insurance in the US. The Affordable Care Act has spurred mergers by introducing rules that push insurers to look for savings. Humana’s 3.2 million Medicare…
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