Tag: Reimbursement

Procedure volume linked to SSIs in CABG, total hip patients

Editor's Note Surgical site infection (SSI) risk for coronary artery bypass graft (CABG) and hip arthroplasty patients is highest in hospitals with low annual procedure volumes, yet these hospitals are excluded from quality reporting, this study finds. Even for high-volume hospitals, year-to-year variation in SSI rates makes past performance an…

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By: Judy Mathias
December 13, 2016
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AHRQ: HACs down 21% since 2010

Editor's Note Hospital-acquired conditions (HACs) fell 21% (3.1 million) between 2010 and 2015, saving nearly 125,000 lives and $28 billion in health care costs, according to a December 12 report from the Agency for Healthcare Research and Quality (AHRQ). Among the findings: Adverse drug events were down 42.3%. Pressure ulcers…

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By: Judy Mathias
December 13, 2016
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Effect of Medicare’s nonpayment program on HACs

Editor's Note Medicare’s Nonpayment Program of 2008, which withholds hospital reimbursement for costs related to hospital-acquired conditions (HACs), was associated with a decline in the incidence of selected HACs in this study. The decline was greater in hospitals with higher Medicare utilization ratios (MURs). In this analysis of nearly 868,000…

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By: Judy Mathias
December 9, 2016
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ASCA lauds passage of 21st Century Cures Act

Editor's Note The Ambulatory Surgery Center Association (ASCA) on December 7 applauded Congress for passing the 21st Century Cures Act, which includes two provisions that benefit Medicare patients and physicians in ambulatory surgery centers (ASCs). The first provision, Section 4012, directs the Department of Health and Human Services (HHS) to…

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By: Judy Mathias
December 9, 2016
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Treatment of AAA differs by country, reimbursement

Editor's Note Despite guidelines from professional societies, significant variation exists in the management of abdominal aortic aneurysm (AAA), especially for AAA size at repair, use of endovascular aneurysm repair (EVAR), and the treatment of elderly patients, this study finds. In countries with a private health care system and fee-for-service reimbursement,…

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By: Judy Mathias
December 6, 2016
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Variation in hospital and surgeon payments for general vs orthopedic procedures

Editor's Note Hospital and surgeon payments for routine general and orthopedic surgical procedures vary greatly, this study finds. Hospital payments averaged $12,744 for general surgery procedures and $22,386 for orthopedic procedures. Orthopedic surgeon reimbursement on average was twice as high as general surgeon payments ($2,349 vs $1,191). Postoperative complications resulted…

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By: Judy Mathias
December 2, 2016
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House passes legislation impacting ASCs

Editor's Note The US House of Representatives on November 30 passed the 21st Century Cures Act that includes two provisions benefiting Medicare patients and physicians in ambulatory surgery centers (ASCs), the Ambulatory Surgery Center Association reports. The first provision creates a public website that allows Medicare patients to compare differences…

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By: Judy Mathias
December 2, 2016
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Henry Ford drops out of total joint bundled-payment program

Editor's Note Henry Ford Health System (Detroit, Michigan) is one of dozens of organizations that have dropped out of Medicare’s bundled payment model program in the past 3 years, the November 29 Modern Healthcare reports. In 2013, three of Henry Ford Health System hospitals participated in the first phase of…

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By: Judy Mathias
November 30, 2016
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Factors associated with postop readmission to nonindex hospital

Editor's Note Patients who were readmitted to a nonindex hospital after having emergency general surgery were significantly more likely to have had their index surgery at a large, teaching, safety-net hospital, this study from Brigham and Women’s Hospital, Boston, finds. Readmission to a nonindex hospital was independently associated with mortality…

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By: Judy Mathias
November 17, 2016
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Impact of disability and social determinants on readmissions

Editor's Note Disability and social determinants of health influence readmission risk differently when added to the Medicare risk adjustment models for the three conditions Medicare focuses on for hospital payment, finds this study. Pneumonia patients who already had difficulties with activities of daily living (ADL) before admission were more likely…

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By: Judy Mathias
November 16, 2016
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