Tag: Reimbursement

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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HRS aims to strengthen electrophysiology advocacy amid growing atrial fibrillation challenges

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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By: Tarsilla Moura
October 23, 2024
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Medicare Advantage insurers prioritize profits over patients, Senate reports

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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By: Matt Danford
October 22, 2024
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Outpatient, ASC clinicians share perspectives on upcoming NOPAIN Act implementation

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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By: Matt Danford
October 16, 2024
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Repeal of CON laws for ASCs expands healthcare access, number of facilities in rural areas

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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By: Tarsilla Moura
October 2, 2024
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Nearly 1 in 3 US rural hospitals at risk of closure

Editor's Note More than 700 rural hospitals, representing 31% of all rural hospitals in the country, are at risk of closure, according to a report from the Center for Healthcare Quality & Payment Reform. Chief Healthcare Executive reported the news August 8. According to the article, 16% of all rural…

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By: Matt Danford
August 15, 2024
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Vertical integration favors HOPDs over ASCs

Editor's Note Medicare and patient out-of-pocket costs are rising as vertical integration results in more procedures moving to hospital outpatient departments (HOPDs) than to ambulatory surgical centers (ASCs), Becker’s ASC Review reported on August 8. The article summarizes a study published July 25 in Science Direct. Described as "physician vertical…

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By: Matt Danford
August 14, 2024
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"Tweener" hospitals eye financial relief after Supreme Court ruling

Editor's Note The Supreme Court’s recent “Chevron” ruling could offer additional financial security to hundreds of so-called "tweener" rural hospitals—those too large to be considered critical access hospitals but too small to be rural referral centers. Modern Healthcare reported the news July 29. According to the article, critical access hospitals,…

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By: Matt Danford
August 1, 2024
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Physician survey illuminates negative impact of prior authorization

Editor's Note The American Medical Association (AMA) annual, nationwide prior authorization survey reveals that over 90% of physicians believe prior authorization negatively impacts patient clinical outcomes. “More telling,” AMA reported July 17, is the fact that 78% of physicians report that this process “sometimes or often” leads to patients abandoning…

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By: Matt Danford
July 24, 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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