Tag: Reimbursement

ACS opposes proposed Medicare physician fee schedule

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…

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By: Judy Mathias
August 6, 2020
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CMS releases 2021 proposed payment rule for ASCs, HOPDs

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…

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By: Judy Mathias
August 5, 2020
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New AHA analysis examines effect of COVID-19 on hospital margins

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%,…

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By: Judy Mathias
July 22, 2020
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Preoperative protocols enhance outpatient total joint outcomes

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…

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By: Catherine Spader, RN
July 22, 2020
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US House of Representatives moves to expand the use of telehealth beyond COVID-19

Editor's Note Leaders of the US House of Representatives telehealth caucus introduced legislation on July 16 to permanently open up access to telehealth services for Medicare patients, the July 16 Fierce Healthcare reports. The bipartisan bill will eliminate restrictions on use in Medicare patients, and it will provide a bridge…

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By: Judy Mathias
July 20, 2020
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AHA: COVID-19 to cost hospitals $323 billion

Editor's Note The American Hospital Association on June 30 released a report on the financial strain facing hospitals and health systems because of COVID-19, with total losses expected to be at least $323 billion in 2020. The total included $120.5 billion in financial losses that hospitals are predicted to see…

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By: Judy Mathias
July 1, 2020
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Declines in patient visits during COVID-19 projected to cost primary care $15 B

Editor's Note Harvard Medical School researchers are projecting that primary care practices will lose more than $15 billion by the end of the year. Because of the steep decline in office visits and fee for service payments from March to May, primary care practices are expected to lose more than…

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By: Judy Mathias
June 29, 2020
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COVID-19 hospitalization costs could reach $17B this year

Editor's Note A new Avalere analysis estimates the cost of COVID-19 hospitalizations could range between $9.6 billion and nearly $17 billion this year, depending on infection and hospitalization trends, the June 23 Fierce Healthcare reports. The analysis considers the cost of hospitalizations in three scenarios: $9.6 billion, if there is…

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By: Judy Mathias
June 24, 2020
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ASC offsets some revenue loss through 'Hospital Without Walls' waiver

Far fewer cases of COVID-19 have been seen in rural areas of the US than in large urban populations. But even healthcare facilities not inundated with COVID-19 patients have sustained revenue losses and disruptions in standard procedures. One major advantage for Heartland Surgery Center in Kearney, Nebraska, was seeing the…

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By: Elizabeth Wood
June 17, 2020
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Proactive payment collection reduces bad debt risk

Establishing policies to collect payment before surgery has grown in importance as high-deductible health plans impose larger out-of-pocket costs on patients. To help manage patients’ expectations about costs and increase the likelihood of collecting payment, some experts believe a culture shift is in order. They say healthcare facilities should be…

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By: Jennifer Lubell
June 17, 2020
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