Tools lacking to assess readmission risks after joint replacement
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…
ACS notifies members of CMS software errors
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.…
CMS extends deadline for reporting 2016 quality data
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…
Total joint PSH helps meet patient satisfaction goals
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…
Reimbursement denials diminish with more precise precertification
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…
Care after surgery drives costs
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…
New administration likely to intervene in bundled-payment initiatives
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…
Colorectal SSIs plummet with evidence-based care bundles
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…
Is pain treatment a risk or reward for ASCs?
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…
Relationship between safety culture and patient experience
Editor's Note In this multi-state study examining the relationship between nurse-reported safety culture and the patient experience, researchers found that modifiable aspects of a hospital’s culture can influence the achievement of high HCAHPS scores in nursing and global domains, which directly impact hospital reimbursement. Three safety culture domains were related…
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- Study: Beta-blockers could increase postoperative stroke risk
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- Private Equity fuels growth of hospital-owned ASCs amidst rising demand, regulatory loopholes
- Outpatient facilities dominate healthcare construction as demand for community-based care grows