Tag: Reimbursement

Reduction in readmissions not linked to increased mortality

Editor's Note Reductions in readmissions associated with the Affordable Care Act have not had the unintended consequence of increasing mortality after hospital discharge, finds this study. Analysis of more than 5 million Medicare patients hospitalized for heart failure, heart attack, or pneumonia, found that reductions in hospital 30-day readmission rates…

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By: Judy Mathias
July 18, 2017
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CMS issues 2018 OPPS/ASC proposed payment rule

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on July 13 issued the CY 2018 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule. CMS is proposing an update of 1.9% for ASCs, which is a combination of a 2.3% inflation update…

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By: Judy Mathias
July 18, 2017
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CMS proposes paying for outpatient total joints

Editor's Note The Centers for Medicare & Medicaid Services on July 13 issued a proposed rule that updates payment rates and policy changes in the Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System. Among the proposals are that Medicare pay for knee replacement procedures performed in outpatient…

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By: Judy Mathias
July 17, 2017
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Distinguishing risk factors for SSIs after pancreatic surgery

Editor's Note Reporting of surgical site infections (SSIs) after pancreatic surgery should distinguish between superficial and organ-space infections, which will require different preventative strategies, this study finds. Results showed that risk factors for superficial and organ-space SSIs after pancreatic surgery differed. Preoperative biliary stenting was an independent risk factor for superficial…

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By: Judy Mathias
July 13, 2017
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Editorial

The inaugural Bundled Payment Bootcamp on June 20 in Nashville, Tennessee, was a timely opportunity for healthcare providers to learn how reimbursement is changing the way they do business. Though the uncertain direction of US healthcare legislation continues to cause consternation, this workshop—which will be presented again in fall 2017—clarifies…

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By: Elizabeth Wood
July 13, 2017
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Do Medicare's latest code changes help or hurt ASCs?

Medicare is increasing approval of higher-acuity procedures performed in the ambulatory surgery center (ASC) setting, creating meaningful opportunities for ASCs. At the same time, however, a number of outpatient procedure codes have been deleted, reduced, or are packaged and considered all-inclusive in a case, without additional payment. “Key changes occurred…

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By: Leslie A. Flowers
July 13, 2017
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Study identifies high-risk groups for readmissions

Editor's Note Comparing rates, characteristics, and costs of hospital readmissions across all ages and insurance types, researchers from Beth Israel Deaconess Medical Center, Boston, found that of more than 12.5 million patients discharged in 2013, approximately 1.8 million were readmitted within 30 days. Medicare patients accounted for 56% of readmissions,…

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By: Judy Mathias
July 11, 2017
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Survey finds compensation key to physician retention

Editor's Note In the annual Physician Practice Preference & Relocation Survey from The Medicus Firm, nearly 3 in 10 physicians say concerns about appropriate compensation is the primary reason they would consider a career change, the July 5 FierceHealthcare reports. More than 17% of respondents say they will “likely” or…

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By: Judy Mathias
July 11, 2017
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Survey: Physicians unprepared for MACRA

Editor's Note A survey of 1,000 physicians by the American Medical Association and KPMG finds that fewer than one in four believe they are well prepared to meet the 2017 requirements of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), KPMG.com reported on June 28. MACRA reshapes how…

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By: Judy Mathias
July 5, 2017
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Value-based purchasing not linked to improvements in quality

Editor's Note In this study, Medicare’s Hospital Value-Based Purchasing (HVBP) program was not associated with improvements in quality measures of clinical process or patient experience. HVBP also was not associated with a significant reduction in two of three mortality measures (ie, acute myocardial infarction or heart failure). It was associated…

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By: Judy Mathias
June 16, 2017
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