It sounds like déjà vu all over again, as Yogi Berra used to say. That is likely to be the first reaction of many ambulatory surgery center (ASC) administrators to the Calendar Year 2014 Ambulatory Surgical Center Payment Proposed Rule.   Pay formula unchanged Medicare payment updates would continue at…

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The Ambulatory Surgery Center Association (ASCA) annually asks members to participate in a “fly-in” to meet with members of Congress to raise awareness about the implications of health care policies. As ASCA vice president of government relations Steve Miller notes, there is nothing like hearing directly from a constituent to…

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A column on managing the OR revenue cycle. Audits of Medicare payments to hospitals are up dramatically. In all, 89% of hospitals reported activity by recovery audit contractors (RACs) in the third quarter of 2012, according to an American Hospital Association (AHA) survey. Here are tips on how your OR…

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Managing patients’ pain is no longer just a clinical goal—it’s a business necessity. The Centers for Medicare and Medicaid Services (CMS) has started incorporating value-based purchasing (VBP) scores, which include customer satisfaction, into hospital reimbursement payments. Of the total VBP score, 30% comes from results from the Hospital Consumer Assessment…

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This year, the quality movement takes a big step with the start of Medicare’s value-based purchasing (VBP) program. Beginning October 1, 2012, part of your hospital’s Medicare payments will be based on your hospital’s performance on a set of quality measures, usually referred to as the core measures and HCAHPS…

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An analysis by Premier of data from 323 of its member hospitals shows they are losing $1.82 billion annually for 12 orthopedic and cardiac case categories because of Medicare reimbursement shortfalls. Lack of evidence-based outcomes data and the rising cost of physician preference items (PPIs) are also cited as reasons…

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July 1, 2011, marks the start of hospitals' first performance period under Medicare's new value-based purchasing program. The initial performance period runs through March 31, 2012. The final rule was released April 29, 2011, for the program, which covers hospitals under the inpatient prospective payment system, with some exceptions. Value-based…

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Fiscal year 2013 will be a milestone for hospital reimbursement. That's the year Medicare's proposed new hospital value-based purchasing program starts. Under value-based purchasing, a portion of hospitals' DRG reimbursement will be based on their performance on quality metrics, including patient perceptions of the quality of care (PPQC). (See March…

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Everything from washers to cars comes with a warranty, so why not health care? Geisinger Health System in Danville, Pennsylvania, introduced health care warranties with an innovative program called ProvenCare. Under the 90-day warranty, one cost covers the surgery and 90 days of follow-up treatment. Geisinger absorbs any additional costs…

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Three more preventable conditions have been added to the list of those Medicare will no longer pay extra for in hospitals in fiscal year 2009, which starts Oct 1, 2008. Medicare also added 13 quality measures for a total of 42 that will need to be reported for a full…

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