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…

Read More

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…

Read More

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…

Read More

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…

Read More

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…

Read More

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…

Read More

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on July 29 issued the 2020 proposed payment rule for ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs), which would increase Medicare hospital outpatient prospective payment system rates by 2.7%. CMS is also proposing to add eight codes to…

Read More

Editor's Note The Hospital Readmission Reduction Program (HRRP), which penalizes hospitals for higher-than-expected readmission rates, did not prompt substantial changes in hospital referral patterns to skilled nursing facilities (SNFs), this study finds. However, readmissions for patients referred to SNFs decreased more than for other patients. In this analysis of nearly…

Read More

Editor's Note Residing in a disadvantaged neighborhood in Maryland and being discharged from a hospital serving a large proportion of disadvantaged neighborhoods were independently associated with increased risk of readmission in this study. 2015 data from Maryland hospitals showed a 14.1% 30-day readmission rate for patients living in neighborhoods in…

Read More

Editor's Note The Centers for Medicare and Medicaid Services (CMS) hospital penalization in the Hospital Acquired Condition Reduction Program (HACRP) was not associated with significant changes in rates of hospital acquired conditions (HACs), 30-day readmissions, or 30-day mortality and does not appear to drive meaningful clinical improvements, this study finds.…

Read More