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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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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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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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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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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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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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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