Category Archives: Hospitals

New rule allows Medicare reimbursement to ambulatory surgery centers for knee replacements, stents

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

CMS proposal would make knee replacements, stents reimbursable at ambulatory surgery centers

Who reads Medicare rules?

Nobody, right?

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

Quality data on ambulatory surgery centers and hospital outpatient services available

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

ProPublica wants to give you tips on hospital billing practices

Health journalists across the country have been reading ProPublica’s accounts of the lengths to which hospitals pursue low-income patients for payment.

Earlier this year, ProPublica revealed that Methodist Le Bonheur Healthcare in Memphis, Tenn., had filed thousands of lawsuits against patients, including its own employees.

In the latest dispatch about medical debt, ProPublica reports that “thousands of people are jailed each year for failing to appear in court for unpaid bills,” citing a court in Coffeyville, Kan., “where the judge has no law degree, debt collectors get a cut of the bail, and Americans are watching their lives — and liberty — disappear in the pursuit of medical debt collection.”

Continue reading

Where have all the patient safety activists gone? … Answer: They’re still around, just a bit quieter

Today, Sept. 17, is the first World Patient Safety Day, declared by the World Health Organization to draw attention to ever-present need – still – to reduce avoidable patient harm in health care settings.

And November marks the 20th anniversary of “To Err is Human,” the National Academy of Medicine’s 1999 report that estimated as many as 98,000 people die a year in United States hospitals. That widely publicized report called for a national agenda to improve patient care processes to make it easier for honest providers to safely treat patients and harder for them to cause harm. Continue reading