AHRQ releases stats on outpatient, inpatient surgeries
Editor's Note According to statistics from the Agency for Healthcare Research and Quality (AHRQ), in 2014, 17.2 million hospital visits (inpatient and outpatient) included surgical procedures. More than half (57.8%) occurred in a hospital-owned outpatient surgery setting, and the remaining (42.2%) were inpatient. Private insurance was the primary payer for…
CMS issues guide for quality payment programs
Editor's Note The Centers for Medicare & Medicaid Services (CMS) has issued a guide summarizing technical assistance resources available to small, underserved, and rural hospitals participating in the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model (AAPM). The guide also provides resources for quality innovation networks and…
National Advocacy Day leads to new cosponsors for ASC legislation
Editor's Note The Ambulatory Surgical Center Quality and Access Act of 2017 (HR 1838/S 1001) has added new cosponsors in the US House of Representatives and was introduced in the Senate, the May 23 Ambulatory Surgery Center Association (ASCA) News Digest reports. Many of the cosponsors signed on as a…
Lower readmission rates linked to Medicare's HRRP
Studies have shown an association between reduced hospital readmission rates and programs implemented as part of the Centers for Medicare & Medicaid Services’ (CMS) Hospital Readmission Reduction Program (HRRP) to reduce healthcare costs and improve quality of care. Researchers from the University of Michigan in Ann Arbor and the RAND…
Effect of Medicare’s Nonpayment Program on HACs
Editor's Note Medicare’s Nonpayment Program of 2008, which withholds hospital reimbursement for costs related to hospital-acquired conditions (HACs), was associated with a declined in the incidence of selected HACs, and the decline was greater in hospitals with a higher Medicare utilization ratio (MUR), this study finds. Of 867,584 Medicare patients…
Implications of reimbursement for postop complications on quality, value
Editor's Note Postoperative complications add an important marginal cost to Medicare payments and lead to a substantial portion of payments to hospitals, this study finds. Analyzing Medicare data for three procedures from 2009 to 2012, payments per uncomplicated surgical procedure were $13,500 for colectomy, $12,300 for total knee arthroplasty, and…
Study: Most hospitals received penalties for excess readmissions
Editor's Note More than half of hospitals were penalized by the Centers for Medicare and Medicaid Services in all five years of the Hospital Readmission Reduction Program (HRRP) initiated by the Affordable Care Act, this study finds. Among the study findings: Penalties doubled since the beginning of the program, from…
CMS releases proposed FY 2018 inpatient payments, policies
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on April 14 issued a proposed rule that would update FY 2018 Medicare inpatient payments and policies. Among the changes, the rule: would increase payment rates by 1.6%, after accounting for inflation and other adjustments required by law includes an…
CMS interim rule delays bundled payment programs
Editor's Note In an interim final rule, the Centers for Medicare and Medicaid Services (CMS) has delayed expansion of the Comprehensive Care for Joint Replacement (CJR) bundled payment program and implementation of its bundled payment programs for cardiac care from July 1 to October 1, 2017, the March 20 Modern…
Effect of opt-out policy for physician supervision of anesthesia
Editor's Note Opting out of the Medicare rule that requires anesthesia to be administered with physician supervision has little or no effect on access to inpatient or outpatient surgery, this study finds. The researchers also found that opting out does not reduce costs, and in fact increases costs for inpatient…
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