Editor's Note The Centers for Medicare & Medicaid Services (CMS) on November 1 released its final payment rule for ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs). CMS added eight codes to the ASC-payable list, including total knee arthroplasty. CMS also removed total hip arthroplasty and seven spine codes from…
Editor's Note This study finds that the estimated cost of waste in the US health care system ranges from $760 billion to $935 billion and accounts for some 25% of healthcare spending. Projected potential savings from interventions to reduce waste, excluding savings from administrative complexity, range from $191 billion to…
Editor's Note Social risk factors were inconsistently associated with surgical site infection (SSI) rates after colectomy or abdominal hysterectomy in this study. In this analysis of 149,741 patients, Medicaid status (a marker for poverty) and living in a low-income zip code were linked to higher SSI rates after colectomy. For…
Editor's Note Data from the Affordable Care Act’s Hospital Readmissions Reduction Program (HRRP) shows that Medicare cut payments to 2,583 hospitals on October 1 because of the number of patients readmitted within a month, the October 1 Kaiser Health News reports. The Centers for Medicare & Medicaid Services (CMS) estimates…
Editor's Note In a proposed rule, the Centers for Medicare & Medicaid Services (CMS) is considering whether to reimburse for percutaneous coronary interventions (PCIs) at ambulatory surgical centers (ASCs), the September 20 tctMD reports. As of May 1, 2019, approximately 22 states allowed for coronary interventions to be done outside…
Editor's Note Strong evidence suggests that most declines in excess readmissions--after implementation of Medicare’s Hospital Readmission Reduction Program (HRRP)--at poorly performing hospitals can be explained by a statistical phenomenon called “regression to the mean [RTM],” this study finds. In RTM, entities farther away from the mean in one period are…
Editor's Note In this study of more than 1 million Medicare patients, 4.8% were super-users of healthcare and incurred 31.7% of Medicare expenditures after surgery. A machine learning approach identified the following as the most significant risk factors linked to super-utilization of healthcare in the year following surgery: hemiplegia/paraplegia weight…
Editor's Note Hospital revisits (ie, treat-and-discharge visits to ED, observation stays, or inpatient readmissions) within 30 days of discharge have increased since implementation of the Hospital Readmission Reduction Program (HRRP), this study finds. Though hospital readmissions have dropped since HRRP was implemented as part of the Affordable Care Act, there…
Editor's Note In its proposed rule, the Centers for Medicare & Medicaid Services (CMS) would give Medicare patients better access to innovative devices beginning next year, the July 30 MassDevice reports. CMS also says it might pay more for “certain transformative new devices” for inpatients, using a new technology add-on…
Editor's Note NarxCare, an opioid-use score based on state prescription databases, is not associated with adverse outcomes or patient satisfaction after elective spine surgery, this study finds. Multivariate logistic regression analysis of 346 elective spine surgery patients did not find statistically significant odds of experiencing adverse events, readmissions, reoperations, and…