Relationship between bariatric surgery outcomes and Medicare expenditures
Editor's Note Medicare payments for bariatric surgery are significantly lower at hospitals with low complication rates, and cost savings are most prominent in patients at highest risk for complications, this study finds. The analysis of 38,374 bariatric surgery patients found a strong correlation between complication rates and episode payments−hospitals in…
Racial disparities in surgical mortality narrowing
Editor's Note Despite concerns that quality improvement efforts may widen disparities, national racial disparities in surgical mortality are narrowing, this study finds. Using Medicare claims data from 2005 to 2014, Harvard researchers found that, overall, national mortality trends improved for both black and white patients by 0.10% and 0.07% per…
US Representatives ask Secretary Price’s assistance with ASC inflationary update measure
Editor's Note A bipartisan group of 24 US Representatives sent a letter to Department of Health and Human Services Secretary Tom Price, MD, on May 26 asking him to use his statutory authority to move ambulatory surgery centers (ASCs) from the Consumer Price Index for All Urban Consumers (CPI-U) to…
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…
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