Annual CMS rules support underserved, under-resourced communities, promote value-based care
Editor's Note Addressing social determinants of health (SDOHs), strengthening emergency preparedness, and improving maternal heath are among the top priorities of the fiscal year (FY) 2025 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) rules released April 10. These and other efforts aim to…
Private payers profit by delaying medical claims
Editor's Note Private payers initially deny reimbursement on 15% of claims, only to later approve more than half of those initial denials, according to a national survey of healthcare institutions published March 21 by Premiere, Inc. Additionally, the denied claims on average tend to be more prevalent for higher-cost treatments…
Study: Postoperative hospital readmissions higher for older Americans
Editor's Note Older Americans are at heightened risk for both short-term and long-term hospital readmission following major surgery, according to a study from Yale University published February 28 in Jama Network Open. Readmission places a major financial strain on health systems, researchers write, pointing out that the total cost…
How data puts the ‘value’ in value-based care
What if a surgeon decided to perform a procedure on a patient that was not totally necessary? It happens more often that one might realize. As recently as August 2023, Forbes published an article that cited a Harvard Business Review report stating that over 50% of lumbar spine surgeries are…
Lack of primary care physicians tied to emergency surgeries
Editor's Note Research shows that Americans who live in areas with a limited number of primary care doctors and nurse practitioners are at a greater risk for emergency surgeries and complications. The findings were published March 4 in the journal Health Affairs. For the study, researchers looked at Medicare patient…
Medicare households have double the healthcare spending burden
Editor's Note The healthcare spending burden of Medicare households was double that of non-Medicare households in 2022, according to an analysis published by KFF (Kaiser Family Foundation) on March 14. Using data from the Consumer Expenditure Survey, KFF found that average health-related expenses made up 13.6% of Medicare households’ total…
Federal probe investigates care quality impact of private equity mergers, acquisitions
Editor's Note Making good on plans announced by the Biden administration in December, federal agencies have launched a public inquiry into how private equity mergers and acquisitions impact patient outcomes, worker safety, and healthcare access and costs, including costs to taxpayers. As reported by Dotmed Healthcare Business News on March…
Medicare offers advance payments for providers impacted by Change Healthcare cyberattack
Editor's Note In a March 9 Press release, CMS announced it will offer emergency funding for healthcare providers experiencing continued disruptions in the wake of a February 21 cyberattack on Change Healthcare, a subsidiary of UnitedHealthGroup and a major processor of medical claims. According to the release, CMS will extend…
Shift to outpatient, emergency services keeps rural hospitals afloat
Editor's Note More CEOs are considering rural emergency hospital (REH) designation, according to a February 12 article in Becker’s Hospital CFO Report. In January 2023, REH was established as a new Medicare provider type to enable struggling rural hospitals to continue operating with outpatient and emergency services only, instead of…
Study examines high emergency department use by transgender Medicare patients
Editor's Note A study showing greater likelihood for transgender (TGD) Medicare patients to use the emergency department highlights the need to train staff in transgender-inclusive care, the authors argue. Conducted by the Brown University School of Public Health, the study was published February 13 in JAMA Internal Medicine. As reported…
Free Daily News
- Legislation proposes to halt Medicare physician payment cuts
- Cigna ties executive pay to patient experience
- Proposed tax credit aims to bolster nurse preceptor ranks
- Study links financial conflicts of interest to favorable robotic bariatric surgery research
- Hospitals double down on ambulatory care expansion with major investments
- Study: Post-laparotomy incisional negative pressure wound therapy fails to reduce infection risk
- FDA announces multiple Class 1 recalls
- Study: ERAS protocol reduces opioid use after cardiac surgery
- Study: Prehabilitation reduces surgical complications, speeds recovery
- Commentary: Studies show how surgeon decisions follow the money