Medicare patient mortality, hospitalizations, and expenditures down
Editor's Note Deaths, hospital stays, and spending all decreased for Medicare patients from 1999 to 2013, this study finds. In 1999, the all-cause mortality rate was 5.3%, and by 2013 that rate had fallen to 4.5%. Hospitalizations decreased from around 35,000 per 100,000 annually to 27,000 per 100,000. Inpatient inflation-adjusted…
Senate bill would let Medicare patients self-pay for medical devices
Editor's Note Four US Senators (two democrats, two republicans) are sponsoring legislation—The Accelerating Innovation in Medicine (AIM) Act—that would increase Medicare patients’ access to new medical devices. Currently, Medicare patients who are interested in self-paying for a device not covered by Medicare face significant administrative obstacles. Under AIM, once a…
Medicare trust fund exhausted by 2030
Editor's Note A report from Medicare trustees on July 22 projects that the Medicare trust fund will be exhausted in 2030. The report also revealed that recipients of Social Security disability benefits could face steep cuts next year. The fund it expected to run out of money in 2016. Congress…
CMS proposes major initiative for total joints
Editor's Note The Centers for Medicare & Medicaid Services is planning to require more than 800 hospitals in 75 geographic areas to participate in a bundled payments initiative for hip and knee replacements. These procedures are among the most common that Medicare beneficiaries receive, and prices vary significantly across geographic…
CMS releases CY 2016 proposed physician payment rule
Editor's Note The Centers for Medicare & Medicaid Services on July 8 released its proposed rule for the physician fee schedule for CY 2016. Physicians will have a 0.5% overall increase in Medicare reimbursement under the rule, which will be finalized this fall. The rule also calls for reimbursement for…
CMS, AMA announce efforts to help with transition to ICD-10
Editor's Note In less than 3 months, healthcare providers will switch from ICD-9 to ICD-10 coding for medical diagnoses and inpatient hospital procedures. To help providers get ready for the October 1 deadline, the Centers for Medicare & Medicaid Services is releasing additional guidance that will allow for flexibility in…
Aetna to buy Humana for $37 Billion
Editor's Note Aetna Inc has agreed to buy rival health insurer Humana Inc for $37 billion in cash and stock, creating the second-largest provider of health insurance in the US. The Affordable Care Act has spurred mergers by introducing rules that push insurers to look for savings. Humana’s 3.2 million Medicare…
New ACS Interactive Web Tool Helps Surgeons Avoid Medicare Penalties
Editor's Note The American College of Surgeons has launched a new web tool to help surgeons navigate and succeed in Medicare’s mandatory quality programs: Physician Quality Reporting System, Electronic Health Record-Meaningful Use, and Value-Based Modifier. Surgeons who do not successfully participate in these programs in 2015 could face up to…
CMS Proposes Changes to the 'Two-Midnight' Rule
Editor's Note On July 1, the Centers for Medicare & Medicaid Services released proposed updates to the “Two-Midnight” rule regarding when inpatient admissions are appropriate for payment under Medicare Part A. The proposed update allows physicians to use their judgment to admit patients for short hospital stays on a case-by-case…
Potential rewards justify efforts to create bundled payment programs
Physician alignment is a key element of current hospital strategy. Last month, we looked at how hospital ORs can use co-management agreements to build strong collaboration with surgeons. Payment reform has created an even more sophisticated option—participation in a bundled payment program. Bundled payment initiatives are more complex than most…
Free Daily News
- Study: COVID-19's impact on oncological surgery offers lessons for future crises
- Study links pandemic stress to persistent increases in nursing-sensitive quality indicators
- Save the date for the 2025 OR Business Management Conference
- Study: Education, exercise improve knee OA with or without prior surgery
- Study: Early surgery outperforms endoscopy for long-term pancreatitis
- Study: Blood thinner, NSAID combination raises bleeding risk
- Hospital financial report predicts stability, high cybersecurity costs for 2025
- IV fluid shortage drives innovation in hospital hydration practices
- FDA Class 1 recalls target anesthesia workstations, ambulatory infusion pumps, ventilators
- Five leadership lessons from an ASC CEO