Waste in US healthcare spending, potential for savings
Editor's Note This study finds that the estimated cost of waste in the US health care system ranges from $760 billion to $935 billion and accounts for some 25% of healthcare spending. Projected potential savings from interventions to reduce waste, excluding savings from administrative complexity, range from $191 billion to…
Association between social risk factors and SSIs after colectomy, abdominal hysterectomy
Editor's Note Social risk factors were inconsistently associated with surgical site infection (SSI) rates after colectomy or abdominal hysterectomy in this study. In this analysis of 149,741 patients, Medicaid status (a marker for poverty) and living in a low-income zip code were linked to higher SSI rates after colectomy. For…
CMS releases final rule on discharge planning
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on September 26 released a final rule that revises discharge planning requirements for hospitals, the September 26 Becker’s Clinical Leadership & Infection Control reports. Among the requirements: Hospitals must prioritize patients’ care goals and treatment preferences during discharge planning. Hospitals…
CMS considering reimbursement for coronary interventions at ASCs
Editor's Note In a proposed rule, the Centers for Medicare & Medicaid Services (CMS) is considering whether to reimburse for percutaneous coronary interventions (PCIs) at ambulatory surgical centers (ASCs), the September 20 tctMD reports. As of May 1, 2019, approximately 22 states allowed for coronary interventions to be done outside…
Effect of ‘regression to the mean’ on excess readmissions
Editor's Note Strong evidence suggests that most declines in excess readmissions--after implementation of Medicare’s Hospital Readmission Reduction Program (HRRP)--at poorly performing hospitals can be explained by a statistical phenomenon called “regression to the mean [RTM],” this study finds. In RTM, entities farther away from the mean in one period are…
EHR efficiency, usability, stress differ by physician gender
Editor's Note There are gender differences in how physicians perceive EHR-related stress, satisfaction, and usability, finds this study. Of 25 ICU physicians who participated in the study, 48% were men and 52% were women. Overall task performance scores were similar, but men reported significantly higher perceived EHR workload stress and…
Machine learning identifies preop risks linked to postop Medicare super-users
Editor's Note In this study of more than 1 million Medicare patients, 4.8% were super-users of healthcare and incurred 31.7% of Medicare expenditures after surgery. A machine learning approach identified the following as the most significant risk factors linked to super-utilization of healthcare in the year following surgery: hemiplegia/paraplegia weight…
Hospital revisits have increased since implementation of HRRP
Editor's Note Hospital revisits (ie, treat-and-discharge visits to ED, observation stays, or inpatient readmissions) within 30 days of discharge have increased since implementation of the Hospital Readmission Reduction Program (HRRP), this study finds. Though hospital readmissions have dropped since HRRP was implemented as part of the Affordable Care Act, there…
CMS proposes giving Medicare patients better access to cutting-edge devices
Editor's Note In its proposed rule, the Centers for Medicare & Medicaid Services (CMS) would give Medicare patients better access to innovative devices beginning next year, the July 30 MassDevice reports. CMS also says it might pay more for “certain transformative new devices” for inpatients, using a new technology add-on…
CMS maintains site-neutral cuts in 2020 proposed rule
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on July 29 issued the 2020 proposed payment rule for ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs), which would increase Medicare hospital outpatient prospective payment system rates by 2.7%. CMS is also proposing to add eight codes to…
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