Medicare penalizes more than half of hospitals for readmissions
Editor's Note Nearly 2,600 hospitals will be penalized for missing readmission targets under Medicare, with a loss of $420 million, Kaiser Health News reports. The average Medicare payment reduction is 0.61% per patient stay; 38 hospitals will receive the maximum cut of 3%. The reductions are based on readmissions of…
ACS Advocating for Critical Access Hospital Relief Act
Editor's Note A central issue discussed at the US House Committee on Ways and Means on July 28 was the Critical Access Hospital (CAH) Relief Act, HR 169, which is supported by the American College of Surgeons (ACS). Currently, for CAHs to receive Medicare Part A reimbursement, physicians must certify…
ASA survey: Who bears responsibility for reducing healthcare costs?
Editor's Note A survey of members of the American Society of Anesthesiologists on the level of responsibility they perceive stakeholders to have in reducing the cost of healthcare and perioperative care delivery found: physicians bear “major responsibility” (38%) physicians bear “some responsibility” (58%) physicians bear “no responsibility” (4%) hospitals bear…
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…
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