For-profit hospitals linked to higher readmission rates
Editor's Note Patients who receive care in for-profit hospitals are more likely to be readmitted than patients in nonprofit public hospitals, this study finds. Using data from 14,307 hospital reports from the national Hospital Readmission Reduction Program for six major diseases, including coronary artery bypass grafting and total hip and…
CMS plans innovative new VBP models
Editor's Note The Centers for Medicare and Medicaid Services (CMS) will be unveiling new payment models centered on high-cost areas as part of ongoing efforts to advance value-based payment (VBP) care, and some models could be mandatory, the September 20 Healthcare Finance News reports. Healthcare providers can expect reduced regulatory…
Orthopedic bundled payment models on the fast track--Part 2
According to a 2016 McKesson report, payers expect value-based reimbursement, including bundled payments, to grow from a third of their business to a majority of it in 5 years. And as noted in Part 1 of this two-part series (OR Manager, September 2018, 1, 13-17), bundles are advancing on multiple…
Effectiveness, safety of bariatric procedures in Medicare patients
Editor's Note Limited evidence exists about the comparative effectiveness and safety of bariatric surgical procedures in Medicare patients, this review study finds. Of 16 studies analyzed, researchers found that bariatric surgery overall, and in particular Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and adjustable gastric banding (AGB) appeared to be…
Effect of Medicare’s bundled payment program on volume, case mix
Editor's Note Hospital participation in Medicare’s Bundled Payments for Care Improvement (BPCI) program for lower extremity joint replacement (LEJR) was not associated with changes in overall procedural volume or the majority of patient case-mix factors, this study finds. The analysis of 1,717,243 Medicare patients found hospital participation in the BPCI…
First year analysis of CJR bundled payment model
Editor's Note This interim analysis of the first year of the Comprehensive Care for Joint Replacement (CJR) bundled payment model finds that CJR may reduce institutional postacute care. Of 75 metropolitan statistical areas (MSAs) that were assigned the bundled payment model and 121 control MSAs, the mean percentage of discharges…
Orthopedic bundled payment models on the fast track--Part 1
The Centers for Medicare & Medicaid Services (CMS) is poised to launch Bundled Payments for Care Improvement (BPCI) Advanced on October 1, 2018, and is continuing its Comprehensive Care for Joint Replacement (CJR) bundled payment model for total hip and knee arthroplasty (THA, TKA). “Orthopedics is the most important service…
Editorial
The Centers for Medicare & Medicaid Services (CMS) on July 12 issued a proposed rule with potential changes to the Medicare Physician Fee Schedule on or after January 1, 2019. According to CMS, the changes would increase the time available for physicians and other clinicians to spend with their patients…
Academic medical centers trailing on cost, quality measures
Editor's Note A new study by consultancy firm Navigant found that academic medical centers are trailing community hospitals across cost and quality measures. Among the findings: Cost per case was 5.8% higher at medical centers, equating to $3.1 million added annual operating expense per center. Cost per case disparity between high…
Hospitals using bundled payments report reduced SNF use and improved care integration
Editor's Note Hospitals participating in Medicare’s Comprehensive Care for Joint Replacement model or its Bundled Payments for Care Improvement initiative for lower extremity joint replacement episodes report reducing skilled nursing facility (SNF) use and improving care coordination, in this survey. Interviews of executives or administrators in each of 22 hospitals…
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