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…
CMS publishes final rule for MU reporting
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on November 1 published a final rule that will allow providers in the Electronic Health Record (EHR) incentive program who previously demonstrated meaningful use (MU) to report to any continuous 90-day reporting period in 2016 and 2017 rather than a…
Medicare VBP bonuses down for 2017
Editor's Note More than 1,600 hospitals will get Medicare bonuses in 2017 under the Hospital Value-Based Purchasing (VBP) program, which is about 200 fewer than last year, the November 2 Modern Healthcare reports. The results are concerning because fewer hospitals are getting bonuses and hospitals aren’t moving in the rankings,…
CMS releases final rule on OPPS/ASC rates
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on November 1 released a final rule that revises the hospital outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) payment system for CY 2017. According to the rule, hospital off-campus facilities will no longer be paid the same…
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