Author's posts
ASC prior authorizations continue to rise
Prior authorization rates are increasing at ASCs, according to HST Pathways’ latest “State of the Industry Report.” The report surveyed 590 ASCs in 47 states. Here are five more insights to know: 1. In 2024, 46% of cases completed preauthorizations, up from 42% in 2023. 2. Only 24% of cases that required a preauthorization in […]
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Physician among those indicted in $8M fraud scheme
A federal jury has convicted a Kentucky physician, among other parties, for his role in a scheme to defraud Medicare and Kentucky Medicaid via Kentucky Addiction Centers, according to a March 26 news release from the Justice Department. What happened? What’s next?
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ASC cancellation rates tick up
ASCs are seeing a slight increase in case cancellations, averaging a 21% cancellation rate in 2024 — up from 20% in 2023, according to HST Pathways’ latest “State of the Industry Report.” Here are four more insights: 1. Seventy-seven percent of healthcare services using text messaging saw improved outcomes. 2. ASCs collected 51% of expected […]
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Gastroenterology volume, revenue up in ASCs
The average monthly gastroenterology case volume at ASCs in 2024 reached 176, up from 167 in 2023, according to HST Pathways’ latest “State of the Industry Report.“ The report surveyed 590 ASCs in 47 states. Here are five more key insights 1. At 59.6%, gastroenterology had the highest operating room block utilization among specialties in […]
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Anesthesia billing’s ‘hidden revenue killers’
Anesthesia billing is complicated and evolving, according to a March 15 blog post from Knack RCM. Here are nine of the “hidden revenue killers,” according to the report: 1. Time-based billing complexity Unlike most specialties, anesthesia billing is time-based. Payers differ in how they calculate time units — Medicare uses decimals, while some commercial plans […]
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Physician executive, medical group to pay $60M+ for false claims suit
A medical group, its subsidiary and its former physician president will pay more than $60 million for allegedly submitting false diagnosis codes to inflate Medicare Advantage payments, according to a March 26 news release from the Justice Department. What happened? Who else is involved?
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Physician pay by specialty
Radiology was the highest-paid physician specialty in 2023, according to MedPAC’s March 13 report to Congress. Here’s the median annual compensation for physicians by specialty in 2023:
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Cardiology cases spiking in ASCs
The number of cardiology procedures performed in ASCs is rising sharply, according to HST Pathways’ latest “State of the Industry Report.” The report surveyed 590 ASCs in 47 states. Here are four more insights: 1. Cardiology operating room times decreased by approximately 28% compared to the previous year. 2. Despite improved efficiency, average net revenue […]
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The new procedures driving spine’s outpatient surge
As spine surgery continues to evolve with technological advances and a push toward value-based care, more procedures are shifting to ASCs. Amid new minimally invasive techniques, improved pain management protocols and surgical innovations, procedures once exclusively done in hospitals are increasingly performed safely and effectively in outpatient settings. Several spine surgeons joined Becker’s recently to […]
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The certificate-of-need anomaly
A March 14 MedPAC report found that while certificate-of-need laws are a major factor in ASC development, other state-specific factors, such as healthcare payment models and demographics, can blunt their effects. Here are five things to know certificate-of-need laws and ASCs, according to the report: 1. More states are moving to change their certificate-of-need laws. […]
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