Research released today shows that from 2016 through 2018, self-insured employers and commercial health insurers in 49 states and the District of Columbia paid 247% more, on average, than what the Medicare program would have paid for the same inpatient and outpatient hospital services.
Researchers from RAND analyzed hospital claims data from 3,112 hospitals in every state except Maryland, which was excluded because the state has an all-payer rate setting model in which hospitals charge prices that are equal to what Medicare and private insurers pay, the report explained. The claims totaled $33.8 billion and came from self-insured employers, six state all-payer claims databases and health plans from 2016 to 2018. Continue reading
Hospitalized older adults who take atypical, or second-generation, antipsychotics for delirium were at increased risk of death from cardiopulmonary arrest, according to a recent study by researchers in Boston.
Despite these known risks, antipsychotic drugs frequently are used to treat or prevent delirium. Delirium (sudden confusion or a rapid change in mental state) affects 15% to 26% of hospitalized older adults. It can lead those affected to harm themselves or others, or otherwise interfere with medical care. Continue reading
Yes, there’s a lot going on these days.
The 2020 election.
(Forget for a minute the cynic’s view that all three things might actually be the same.)
We’re forgetting or perhaps just distracted from drawing our readers’ attention to a preventable problem that kills some 200,000 people a year. Continue reading
Knee replacement surgeries and stenting procedures will now be reimbursed in free-standing ambulatory surgery centers for Medicare fee-for-service beneficiaries as of Jan. 1 under a new rule finalized by the Centers for Medicare & Medicaid Services on Friday.
The controversial policy shift will mean hundreds, if not tens of thousands, of older patients will now have these complex procedures in a facility not attached to a hospital, and will go home the same day. Continue reading
Who reads Medicare rules?
They’re long, boring, hard to read because of the small type in narrow columns and they’re full of repetition and jargon.
But just in case you have a sleepless night, I recommend pulling up proposed or final rules for an IPPS, (inpatient prospective payment system) or an OPPS (outpatient prospective payment system) or a PFS (physician fee schedule), for starters. Continue reading
As my colleague Joyce Frieden reported for MedPage Today on Tuesday, in 2020, reporters will be able to compare the quality of some hospital outpatient departments and some ambulatory surgical centers for the first time, using metrics that are somewhat similar to those used to check up on hospital quality.
After all, some 60% of surgical procedures today are performed in an outpatient setting, so patients have a right to know what policies and procedures the facility uses to safeguard against errors and complications. Continue reading