HHS releases final interoperability rules
Editor's Note The US Department of Health and Human Services (HHS) on March 9 released two interoperability rules, which will give patients direct access to their healthcare data. These rules mark the most extensive healthcare data sharing policies the federal government has implemented, requiring public and private entities to share…
Effect of total joint bundled payment program on patient selection
Editor's Note In this study, researchers found little to no significant change in the characteristics of patients having total hip and knee replacement surgery after the Centers for Medicare & Medicaid Services introduced the mandatory bundled payment programs in selected metropolitan statistical areas. The analysis included a matched set of…
CMS proposes changes to total joint bundled payment program
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on February 20 issued a rule proposing changes to the Comprehensive Care for Joint Replacement (CJR) program, which bundles payments to acute care hospitals for hip and knee replacement surgical procedures. CMS proposes extending the CJR model for an additional…
Association of geriatric-specific characteristics with postop readmissions
Editor's Note In this study from the University of Virginia, new geriatric-specific characteristics were found to raise the risk of elderly surgical patients having unplanned readmissions within a month of leaving the hospital. The four geriatric-specific risk factors for readmission include: cognitive impairment requiring another person to sign the patient’s…
Medicare may overpay for postop care
Editor's Note Medicare may be overpaying surgeons for postoperative care they provide to patients, according to a new Rand Corporation analysis in the January 23 New England Journal of Medicine. The authors of the analysis suggest that federal officials should incorporate ways to more objectively measure the amount of postoperative…
Study challenges concerns about HRRP
Editor's Note This study from the division of cardiology at Dallas’ University of Texas Southwestern Medical Center and the Yale School of Medicine, New Haven, Connecticut, challenges concerns about Medicare’s Hospital Readmission Reduction Program (HRRP)--ie, that it leaves patients more vulnerable and increases postdischarge mortality rates. Analyzing inpatient and outpatient…
Spending, quality effects of Medicare’s bundled payments for lower-extremity joint replacement
Editor's Note In this study, researchers found that over a 3-year period, compared to no participation, participation in Medicare’s Bundled Payments for Care Improvement (BPCI) program was associated with a 1.6% decrease in average lower extremity joint replacement spending with no changes in quality, driven by early participants. When looking…
House passes year-end bill that repeals ACA taxes including medical device tax
Editor's Note The US House of Representatives on December 17 passed a year-end spending bill that repeals several Affordable Care Act (ACA) taxes, including the 40% tax on generous health insurance plans and the 2.3% tax on the sale of medical devices, the December 17 Reuters reports. The bill also…
CMS expects greater scrutiny from Joint Commission surveyors
[This article from the January 2020 issue of OR Manager summarizes information presented at the 2019 OR Manager Conference. The presenter offered tips to help attendees comply with Joint Commission standards and achieve a successful Joint Commission survey. Readers are asked to note the following points of clarification: The presentation…
To avoid penalties, know the rules for quality reporting
Keeping up with Medicare’s regulatory and reporting requirements for ambulatory surgery centers (ASCs) can be as difficult as ensuring physicians arrive to start their cases on time. “Regulations can change frequently,” says Gina Throneberry, MBA, RN, CASC, CNOR, director of education and clinical affairs for the Ambulatory Surgery Center Association…
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