Editor's Note In this study, Medicare’s Comprehensive Care for Joint Replacement bundled payment model resulted in a decrease of $5,577 in total spending per episode. Most hospital savings came from implants and supplies, and most postacute care savings came from decreased use of inpatient rehabilitation and skilled nursing facility care.…

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Editor's Note The Centers for Medicare & Medicaid Services (CMS) and care providers lack the predictive models needed to assess risks for readmission after joint replacements, finds this study. Researchers tested the applicability of the Carlson Comorbidity Index, Elixhauser Comorbidity Index, and CMS Hierarchical Condition Category to see whether any…

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Editor's Note The American College of Surgeons (ACS) on January 20 notified members that it had received a letter from the Centers for Medicare & Medicaid Services (CMS) saying new moderate sedation codes that took effect January 1 were incorrectly bundled into several surgical procedures codes in CMS payment software.…

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Editor's Note The Centers for Medicare & Medicaid Services (CMS) on January 17 announced a deadline extension for reporting CY 2016 electronic Clinical Quality Measure data to avoid a 2.7% payment adjustment in FY 2018. The extension applies to hospitals and critical access hospitals participating in the Hospital Inpatient Quality…

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When leaders at Memorial Healthcare, a 154-bed community hospital in Owosso, Michigan, wanted to get a jump on preparing for bundled payments, they chose to focus on total hip and knee surgery. Creating a perioperative surgical home (PSH) for this patient population paid off in enhanced patient satisfaction and reductions…

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With no increases in reimbursement on the healthcare horizon, the leadership team at Advocate Good Samaritan Hospital in Downers Grove, Illinois, knew they needed to maximize revenue capture. The team, including Katrina Spears, MAOL, manager of business and informatics, used Lean methodology to improve precertification and reduce denials, resulting in…

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Editor's Note This study finds that where surgical patients go after they are discharged varies widely, and that variation leads to huge differences in how much their care costs. Variation in postacute care spending between lowest and highest quintiles differed 129% for total hip replacement, 103% for coronary artery bypass…

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Editor's Note The Centers for Medicare & Medicaid Services (CMS) issued a final rule December 20, 2016, on its cardiac and orthopedic bundled-payment initiatives, but President-elect Donald Trump’s nominee for Health and Human Services secretary, Rep Tom Price (R-Ga) is likely to stop the cardiac mandatory initiative scheduled to start…

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Surgical site infections (SSIs) not only harm patients, but also can squeeze a hospital’s bottom line through increased costs and reduced reimbursement. Patients undergoing colorectal surgery are particularly at risk for SSIs, according to data from the National Healthcare Safety Network (NHSN), but an effective multidisciplinary team and an evidence-based…

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A growing number of new devices, procedures, and drugs are becoming available to alleviate pain, especially the chronic type that lingers after incurring an injury or undergoing surgery. Pain management has become a medical specialty, and most pain relief procedures are appropriate for ambulatory surgery centers (ASCs). Some ASCs make…

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