Tag: Reimbursement

Can your hospital survive the growing dominance of ASCs?

Of the approximately 57 million surgical procedures performed annually in the US, it is estimated that hospital inpatient procedures (overnight admissions) account for less than 20% of cases. Many procedures once performed in hospital outpatient surgery departments (HOPDs) have moved to ambulatory surgery centers (ASCs) over the past 15 years,…

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By: Thomas A. Blasco, MD, MS
January 13, 2020
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Spending, quality effects of Medicare’s bundled payments for lower-extremity joint replacement

Editor's Note In this study, researchers found that over a 3-year period, compared to no participation, participation in Medicare’s Bundled Payments for Care Improvement (BPCI) program was associated with a 1.6% decrease in average lower extremity joint replacement spending with no changes in quality, driven by early participants. When looking…

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By: Judy Mathias
January 7, 2020
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Providing cost-benefit analysis for ERAS-related solutions

Enhanced Recovery After Surgery The implementation of Enhanced Recovery After Surgery (ERAS) is based on the concept of organizing care around the patient, addressing medical condition needs to optimize readiness for surgery and reducing the likelihood of postoperative complications. Efficacy is measured by how well we perform according to these…

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By: OR Manager
December 17, 2019
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To avoid penalties, know the rules for quality reporting

Keeping up with Medicare’s regulatory and reporting requirements for ambulatory surgery centers (ASCs) can be as difficult as ensuring physicians arrive to start their cases on time. “Regulations can change frequently,” says Gina Throneberry, MBA, RN, CASC, CNOR, director of education and clinical affairs for the Ambulatory Surgery Center Association…

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By: OR Manager
December 17, 2019
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Hospital-based care coordination strategies linked to CMS star ratings

Editor's Note Care coordination strategies were found to be associated with high overall hospital quality star ratings from the Centers for Medicare & Medicaid Services (CMS) in this study. A total of 710 general acute care noncritical access hospitals that received star ratings and responded to the 2015 American Hospital…

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By: Judy Mathias
November 21, 2019
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2020 OR Business Management Conference around the corner

Anyone seeking a break from the winter weather and a stimulating educational experience will find both at the 2020 OR Business Management Conference (ORBMC), which takes place January 27-30 in Weston, Florida. The highly relevant and timely presentations, along with networking events that connect OR business professionals with colleagues and…

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By: Elizabeth Wood
November 18, 2019
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CMS releases 2020 final payment rule for ASCs, HOPDs

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…

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By: Judy Mathias
November 4, 2019
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Waste in US healthcare spending, potential for savings

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…

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By: Judy Mathias
October 9, 2019
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Association between social risk factors and SSIs after colectomy, abdominal hysterectomy

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…

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By: Judy Mathias
October 3, 2019
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CMS: New round of readmission penalties affects 2,583 hospitals

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…

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By: Judy Mathias
October 2, 2019
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