Across the US, surgical services are estimated to comprise around 20% of national health spending and typically generate up to 70% of total health system revenue.1, 2 That makes surgical services the largest revenue generator for a hospital, supporting access to numerous other healthcare services. Considering the average hospital has…
Editor's Note The Centers for Medicare and Medicaid Services (CMS) on October 6 released guidance on how it will implement an interim final rule that requires hospitals and critical access hospitals to report data on COVID-19 and flu patients. CMS says failure to report specified data may lead to termination…
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on September 2 issued its final inpatient prospective payment system (IPPS) rule, which will: increase IPPS rates by 2.9% in FY 2021 for hospitals that report quality data and are meaningful users of electronic health records, resulting in an increase…
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on August 25 issued emergency regulations requiring all hospitals and critical access hospitals to report daily COVID-19 data. The data includes: number of confirmed or suspected COVID-19 positive patients being treated ICU beds occupied availability of ventilators, PPE, and other…
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on August 17 updated its patient payment guidance to increase hospital reimbursement for care of COVID-19 patients by 20%. The payment increase will take effect September 1. Among requirements for hospitals to receive the Medicare payment increase: Patients must have…
Leaders at Virginia Commonwealth University (VCU) Health System in Richmond started the journey to become an Enhanced Recovery After Surgery (ERAS) hospital in 2016 with the following problem statement: Across surgical specialties, and regardless of superior surgical technique, perioperative care, and anesthesia care, patients can experience extended length of hospital…
Editor's Note The American College of Surgeons (ACS) on August 4 announced that it is strongly opposed to the Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule proposed rule for CY 2021. In the fee schedule, which is set to take place January 1, 2021, Medicare payments will…
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on August 4 released the 2021 proposed payment rule for ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs). Among the proposals in the rule: CMS proposes to expand the number of procedures that Medicare would pay for when performed…
Editor's Note A new analysis prepared for the American Hospital Association (AHA) by Kaufman, Hall & Associates LLC examines COVID-19’s financial effects on hospitals and healthcare systems. The analysis, released July 21, finds that without further government support, hospital margins in the second half of 2020 could fall to -7%,…
On January 1, 2020, the Centers for Medicare & Medicaid Services (CMS) began reimbursing healthcare providers for total hip arthroplasty performed in outpatient hospital settings and total knee arthroplasty in ambulatory surgery centers (ASCs), thereby opening the floodgates for explosive growth in outpatient total joint arthroplasty (TJA). About a million…