Hospital teaching status and Medicare payments, outcomes
Editor's Note Risk-adjusted Medicare payments for an episode of surgical care were similar at teaching and nonteaching hospitals for three complex surgical procedures, this study finds. Teaching vs nonteaching hospital payments included: abdominal aortic aneurism repair−$29,946 vs $27,993 pulmonary resection−$25,407 vs $26,813 colectomy−$34,949 vs $30,352. Very major teaching hospitals had…
CMS extends deadline for reporting 2016 quality data
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on January 17 announced a deadline extension for reporting CY 2016 electronic Clinical Quality Measure data to avoid a 2.7% payment adjustment in FY 2018. The extension applies to hospitals and critical access hospitals participating in the Hospital Inpatient Quality…
Adding new business to the ASC, one procedure at a time—Part 1
An ambulatory surgery center (ASC) looking to expand its market may want to add new procedures, but only after careful consideration of resource investment versus ultimate benefit. In the first of a three-part series, OR Manager explores surgical specialties that appear to show promise for the outpatient setting. One of…
Care after surgery drives costs
Editor's Note This study finds that where surgical patients go after they are discharged varies widely, and that variation leads to huge differences in how much their care costs. Variation in postacute care spending between lowest and highest quintiles differed 129% for total hip replacement, 103% for coronary artery bypass…
New administration likely to intervene in bundled-payment initiatives
Editor's Note The Centers for Medicare & Medicaid Services (CMS) issued a final rule December 20, 2016, on its cardiac and orthopedic bundled-payment initiatives, but President-elect Donald Trump’s nominee for Health and Human Services secretary, Rep Tom Price (R-Ga) is likely to stop the cardiac mandatory initiative scheduled to start…
Editorial
Healthcare consumers and providers alike are watching to see what changes will occur under the administration of President-elect Donald Trump. Thus far, at least a partial repeal of the Affordable Care Act (ACA) seems likely. That’s in part because US Rep Tom Price (R-GA) is Trump’s pick for Health and…
Procedure volume linked to SSIs in CABG, total hip patients
Editor's Note Surgical site infection (SSI) risk for coronary artery bypass graft (CABG) and hip arthroplasty patients is highest in hospitals with low annual procedure volumes, yet these hospitals are excluded from quality reporting, this study finds. Even for high-volume hospitals, year-to-year variation in SSI rates makes past performance an…
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 decline in the incidence of selected HACs in this study. The decline was greater in hospitals with higher Medicare utilization ratios (MURs). In this analysis of nearly 868,000…
ASCA lauds passage of 21st Century Cures Act
Editor's Note The Ambulatory Surgery Center Association (ASCA) on December 7 applauded Congress for passing the 21st Century Cures Act, which includes two provisions that benefit Medicare patients and physicians in ambulatory surgery centers (ASCs). The first provision, Section 4012, directs the Department of Health and Human Services (HHS) to…
Impact of disability and social determinants on readmissions
Editor's Note Disability and social determinants of health influence readmission risk differently when added to the Medicare risk adjustment models for the three conditions Medicare focuses on for hospital payment, finds this study. Pneumonia patients who already had difficulties with activities of daily living (ADL) before admission were more likely…
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