It happens every now and then. You’re moving along at a pretty good clip, enjoying the scenery and the thrill of the ride. Then, all of a sudden, you’re forced to slam on the brakes to avoid a family of ducks waddling across the road. Without any kind of warning, you find yourself at a […]
For the past few years, most anesthesia practices have had trouble recruiting qualified providers to meet the needs of the facilities they serve. In June 2024, the ASA published an article entitled “Anesthesia Workforce Shortage Poses Threat to Health Care.” While it is true that some practices with consistent surgical volume and a positive payer […]
As you know from last week’s alert, the Centers for Medicare and Medicaid Services (CMS) has released its 2025 fiscal year (FY) Inpatient Prospective Payment System (IPPS) final rule, which goes into effect—in large part—on Oct 1 of this year. Part of that rule addresses multiple programs and requirements dedicated to quality measurement. Over the […]
After just presenting to our readers what the Centers for Medicare and Medicaid Services (CMS) has in store for hospital outpatient departments with its recently published 2025 OPPS proposed rule, we now have the 2025 Inpatient Proposed Payment System (IPPS) final rule to consider. On August 1, CMS released the nearly 3,000-page final rule that […]
“I wish a Ford and a Chevy would still last 10 years like they should,” crooned country legend Merle Haggard back in the 80s. There was a perception back then that American products, in general, were falling behind in terms of their reputation for quality—especially when compared to foreign imports. In response, Ford initiated a […]
In the early 1980s, Medicare started reducing payment rates for anesthesia. Over the course of a few years, the disparity between commercial payment rates and Medicare rates continued to grow. This encouraged many practices to focus aggressively on payer contracting as a means of offsetting the impact of declining Medicare rates. For many years, this […]
The 2025 Outpatient Prospective Payment System (OPPS) proposed rule (PR) contains a number of provisions. Last week, we mainly focused on payment-related issues. Today’s article will focus on proposed changes to the hospital conditions of participation (CoPs)—a collection of requirements that has implications for whether or not a hospital can participate with the Medicare program. […]
On July 10, 2024, the Centers for Medicare and Medicaid Services (CMS) released its 2025 Outpatient Prospective Payment System (OPPS) proposed rule (PR) relative to hospital outpatient services. The following will act to summarize the key elements of the PR. General OPPS Payment The OPPS payment rates for hospitals that meet the applicable quality reporting […]
It has often been said that managing an operating room suite is like sitting on a three-leg stool where hospital administration represents one leg, the surgeons provide the second and anesthesia the third. Ideally, the administration defines the goals and objectives and recruits surgeons who are qualified and eager to produce. The problem is that […]
