Shifts in case mix bode well for future of outpatient surgery
Before COVID-19 emerged as the biggest disruptor of 2020, many ambulatory surgery centers (ASCs) had been growing volume and receiving Medicare reimbursements for an increasing number of procedures. Stopping elective procedures in the spring was a significant setback, especially for smaller, independent facilities, notes a Global Healthcare Advisors (GHA) brief,…
CMS: How to prepare for COVID-19 vaccine
Editor's Note The Centers for Medicare and Medicaid Services (CMS) on November 5 released a set of toolkits and enrollment actions to take to administer the COVID-19 vaccine when it’s available. Many Medicare-enrolled providers don’t have to take any actions until the vaccine is available. Some Medicare-enrolled providers must also…
CMS penalizes 2,545 hospitals for high readmissions
Editor's Note The Centers for Medicare and Medicaid Services (CMS) will penalize and reduce a year’s worth of payments to nearly half of the nation’s hospitals because of 30-day readmission rates, the November 2 Kaiser Health News reports. The penalties are part of the ninth year of the Hospital Readmissions…
Think 'outside the blocks' to shore up balance sheets
Editor’s Note: This article from Whitman Partners addresses some ways OR nurse leaders can help their health systems recover from the financial fallout and disruption in normal processes caused by the COVID-19 pandemic. Whitman Partners is a Portland, Oregon-based specialty search firm dedicated to placing directors of surgical services at…
Consider a PSH as a post-pandemic strategy
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…
CMS threatens to withhold payments from hospitals not reporting COVID-19, flu data
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…
CMS issues final inpatient payment rule for FY 2021
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…
CMS issues emergency regs on daily COVID-19 reporting for hospitals, critical access hospitals
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…
CMS to increase pay to hospitals for care of COVID-19 patients
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…
What does it take to become an ERAS hospital?
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…
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