Tag: payment rate

Anthem anesthesia payment policy reversal prompts statement from American Society of Anesthesiologists

Editor's Note The American Society of Anesthesiologists (ASA) commended Anthem's reversal of a policy to deny anesthesia payment based on arbitrary time limits, which was set for February 2025 in three states. “The now-rescinded policy was inconsistent with prevailing standards, regulations and billing norms, and revealed a diminished dedication to…

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By: Matt Danford
December 6, 2024
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AHA's Congressional "wish list" calls for financial relief, patient access, workforce protections

Editor's Note   In a November 12 letter to Congress, the American Hospital Association (AHA) outlined its priorities for the lame-duck legislative session, focusing on measures to stabilize hospitals and health systems facing significant financial and operational pressures. If enacted, these recommendations would support the nation’s healthcare infrastructure amid rising…

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By: Matt Danford
November 14, 2024
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2025 Medicare reimbursement cuts spark concern among physicians

Editor's Note Doctors facing inflationary and operational cost increases are decrying recently finalized 2025 Medicare reimbursement rates, according to a November 4 report in Healthcare Dive. The 2025 rates reduce physician payments by 2.9% while increasing rates for hospital outpatient departments and ambulatory surgery centers (ASCs) by 2.9%, the outlet…

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By: Matt Danford
November 5, 2024
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Traveler tightrope: OR leaders balance best practices, reduction strategies

Takeaways Providers are generally seeking to reduce use of travelers through strategies such as float pools, training programs, and cultural reforms. However, travelers remain useful as a bridge to permanent staff and for difficult-to-fill positions. Best practices for selection, onboarding, team integration, and performance evaluation are essential for maximizing return…

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By: Cynthia Saver, MS, RN
September 25, 2024
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2025 IPPS payment rule criticized

Editor's Note The American Hospital Association (AHA) criticized new inpatient prospective payment system rates issued August 1 by the Centers for Medicare and Medicaid Services (CMS), citing the potential of financial struggles for hospitals and reduced access for patients, particularly in rural or underserved areas. Under the new rule, most…

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By: Matt Danford
August 6, 2024
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High RN, higher travel RN pay reflect post-pandemic demand

Editor's Note Heightened demand has made nursing lucrative relative to other professions, especially since the COVID-19 pandemic, according to a May 9 report from healthcare job marketplace Vivian Health. Based on the firm’s proprietary salary data as well as information from the Bureau of labor Statistics, Vivian estimates registered nurses…

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By: Matt Danford
July 19, 2024
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Hospitals, health groups criticize CMS pay proposals

hospital CFO report logo

Editor's Note Hospital groups are criticizing CMS' proposed 2.6% pay increase for 2025, deeming it insufficient for nonprofit hospitals with operating margins near or below zero, according to a July 11 article in Becker’s Hospital CFO Report. The American Hospital Association and America's Essential Hospitals argue the rise won't cover…

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By: Matt Danford
July 12, 2024
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CMS releases proposed Medicare payment rates for outpatient, ASC services

Editor's Note On July 10, CMS proposed Medicare payment rates for hospital outpatient and ambulatory surgery center (ASC) services for 2025.  Published annually, the Hospital Outpatient Prospective Payment System (OPPS) and ASC Payment System Proposed Rule will have a 60-day comment period, which this year ends September 9 prior to…

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By: Matt Danford
July 10, 2024
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Rural hospitals contend with challenging opportunities

Rural hospitals in the US have been facing a prolonged, multifaceted crisis. The literature presents several reasons for why healthcare facilities in rural areas struggle, including shrinking budgets, rising chronic illness and public health issues like addiction and obesity, poor telehealth and broadband access, aging populations, deteriorating mental health, and…

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By: David C. Walsh
June 24, 2024
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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…

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By: Matt Danford
April 12, 2024
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