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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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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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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Ask any group of ambulatory surgery center (ASC) administrators their greatest concern, and the most likely answer will be “reimbursement.” Specifically, they will say Medicare payments do not keep up with their costs and revenue expectations. It does not help that the rules and formulas established by the Centers for…

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Editor's Note A Deloitte survey of physicians found that three out of four believe electronic health records (EHRs) increase practice costs, which outweigh any efficiency savings, and seven out of 10 say EHRs reduce their productivity, the October 3 Healthcare Informatics reports. Nearly two-thirds (62%) of respondents want EHRs to…

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Editor's Note In this study, substantial variation was observed across hospitals in Medicare episode payments for patients rescued from surgical complications, and higher payments were not associated with improved clinical performance. Medicare payments for patients rescued at the highest-cost hospitals were two- to threefold higher than the lowest-cost hospitals for…

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Editor's Note Variation in hospital readmissions is highest on the first day and declines rapidly in the first 7 days after discharge, which suggests that most readmissions after 7 days may be due to community and household factors beyond the hospital’s control, this study finds. The analysis included hospital readmissions…

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Editor's Note In this study, nonhierarchical modeling to measure hospital performance frequently misclassified average-quality hospitals as low quality, and hierarchical modeling misclassified low-quality hospitals as average. At low hospital case volumes, hierarchical modeling missed 90.6% of low-quality hospitals, and nonhierarchical modeling missed 65.3%. However, 38.9% of hospitals classified as low-quality…

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Editor's Note Comparing the Comprehensive Care for Joint Replacement (CJR) program’s broad definition of a patient’s episode of care (ie, initial hospitalization until 90 days after discharge) with a clinically narrow definition of an episode of care, researchers found that hospital performance was consistent no matter which definition was used.…

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Editor's Note In the first 21 months of the Bundled Payments for Care Improvement (BPCI) initiative for total hips and knees, Medicare payments declined more for BPCI participating hospitals than nonparticipating hospitals, without a significant change in quality outcomes, this study finds. For the analysis, 31,700 total joints at 176…

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