Editor's Note Escalating administrative hurdles from insurers are heightening tensions between healthcare payers and providers who criticize the measures for threatening patient care, Modern Healthcare reported January 22. According to the article, policies attracting criticism include stringent prior authorization rules, claims denials, and new fees for appeals. For their part,…

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Editor's Note Healthcare data inaccuracies occur at rates as high as 26.9% in hospitals, with related inefficiencies costing providers up to $20 million annually, HealthLeaders reported January 8. According to the article, these inaccuracies stem from factors such as data entry mistakes, outdated information, inconsistent data standards, and system integration…

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“Surgeons are the only people trained to provide surgery—life-saving care," says Carrie Zlatos, chief of legislative and political affairs at the American College of Surgeons (ACS). "They are an essential element of a community-based healthcare system. Regardless of where you live, everyone should have access to full quality surgical care.”…

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Stem cell therapy is poised to revolutionize regenerative medicine. As these therapies advance, they may alter or even replace certain invasive surgical procedures. Already undergoing advanced clinical trials, orthopedic applications are likely candidates for attracting the earliest adopters. Results so far indicate significant potential for providing alternatives to implants, grafts,…

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Takeaways • Documentation and coding procedures are rife with opportunity for cost savings. • Passed in 2022, the No Surprises Act is designed to protect insured patients from surprise billing for emergency services from out-of-network providers. However, the result has been nearly 40% cuts in reimbursements to anesthesiologists. • OR…

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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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Editor's Note The Heart Rhythm Society (HRS) announced the formation of Heart Rhythm Advocates, a new 501(c)(4) nonprofit advocacy organization aimed at bolstering support for cardiac electrophysiology (EP), Cardiac Rhythm News October 23 reports. This initiative complements HRS's existing 501(c)(3) nonprofit structure and responds to the increasing prevalence of atrial…

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Editor's Note A Senate report reveals that Medicare Advantage insurers are increasingly prioritizing profits over patient care by ramping up the use of prior authorization to deny necessary services, particularly post-acute care, for older adults, Becker’s Hospital Review reported October 17. In May 2023, the Senate Permanent Subcommittee on Investigations…

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Editor's Note On October 14, Anesthesiology News published a monograph featuring clinical perspectives on how “those working in the trenches of postsurgical pain management” are preparing for the Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act, which outlines new, separate Medicare reimbursement for certain non-opioid analgesics in outpatient and ambulatory…

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Editor's Note This fall 2024 study published by the CATO Institute found that repealing Certificate-of-Need (CON) laws for ambulatory surgical centers (ASCs) would significantly increase the number of ASCs, improving patient access to affordable and high-quality care. By examining six states that repealed ASC-specific CON laws between 1991 and 2019,…

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