Tag: Reimbursement

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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CMS publishes final rule for MU reporting

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on November 1 published a final rule that will allow providers in the Electronic Health Record (EHR) incentive program who previously demonstrated meaningful use (MU) to report to any continuous 90-day reporting period in 2016 and 2017 rather than a…

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By: Judy Mathias
November 3, 2016
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Medicare VBP bonuses down for 2017

Editor's Note More than 1,600 hospitals will get Medicare bonuses in 2017 under the Hospital Value-Based Purchasing (VBP) program, which is about 200 fewer than last year, the November 2 Modern Healthcare reports. The results are concerning because fewer hospitals are getting bonuses and hospitals aren’t moving in the rankings,…

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By: Judy Mathias
November 3, 2016
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CMS releases final rule on OPPS/ASC rates

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on November 1 released a final rule that revises the hospital outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) payment system for CY 2017. According to the rule, hospital off-campus facilities will no longer be paid the same…

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By: Judy Mathias
November 2, 2016
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Effectiveness of PSH model in pediatric settings

Editor's Note Use of the Perioperative Surgical Home (PSH) model in patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion improved surgical outcomes, this study finds. A multidisciplinary group created evidence-based protocols for preoperative, postoperative, and postdischarge patient care. Anesthesiologist comanagement of patients also allowed a new pathway for patients…

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By: Judy Mathias
November 1, 2016
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CMS publishes final MACRA rule

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on October 14 issued a final rule with comment period for implementing provisions of the new physician payment system required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), according to the October 14 Modern Healthcare. The rule…

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By: Judy Mathias
October 17, 2016
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