Hospital

Individuals with a history of a neurological disorder prior to COVID-19 infection experienced an increased likelihood of acute care hospital re-encounters at both 30 days and 4 months, according to findings published in GeroScience.

The rate of hospital-acquired Clostridioides difficile infection improved by 39% at a Quebec hospital when 70% of antibiotic users took a three-strain Lactobacillus probiotic under a pharmacy-driven protocol, researchers reported.

Among patients referred from a short-stay acute medical unit, those receiving a comprehensive geriatric assessment at home had similar clinical outcomes as those who received the same assessment in the hospital, data show.

Telehealth treatment in an intensive acute care psychiatric setting was associated with equivalent patient satisfaction as in-person treatment, according to study results published in Journal of Clinical Psychiatry.

Support staff and Black and Latinx workers with and without patient care faced the highest risk for SARS-CoV-2 infection in a study of nearly 4,000 hospital employees and clinicians in New Jersey.

The Mayo Clinic in Rochester, Minnesota, has been ranked by U.S. News & World Report as the No. 1 hospital in the country for diabetes and endocrinology, according to its 2020-2021 Best Hospitals rankings.

Incorporation of brief suicide prevention interventions into routine acute care practice may reduce subsequent suicide attempts, according to results of a systematic review and meta-analysis published in JAMA Psychiatry.

One hospital system protected its patients with advanced HF and cardiac transplant from COVID-19 by safely moving them from a central hospital, which was redesigned to care for patients with COVID-19, to a cardiac specialty hospital with no patients with COVID-19, according to a paper published in The Journal of Heart and Lung Transplantation.

The general urban population in China exhibited increased risk for daily hospital admission for depression associated with short-term ambient air pollution exposure, according to study results published in American Journal of Psychiatry.

It is my understanding that in 2020 the Hospital Outpatient Prospective System rate reimbursement will be $11,899.38 for TKA (CPT code 27447). The final 2020 Ambulatory Payment Classification base rate for CPT code 27447 will be $8,609.17. A ligament reconstruction (CPT code 27429), in comparison, has a reimbursement of $10,717.80. It is my understanding that these rates do not include the professional fee, which is between $1,350 and $1,450 for a TKA. Thus, the reimbursement for a Medicare outpatient TKA is approximately $10,000 including the professional fee. Most orthopedic groups that perform outpatient TKAs state that the average cost including all direct, indirect and variable expenses is approximately $9,000 unless fixed costs are not included in the analysis or if prosthetic costs are reduced significantly. This is not, as yet, a bundled payment reimbursement. If that were the case, it would be imperative for the group to have a “stop loss insurance policy” that would cover the costs of an “unintended complication” in the first 90 days postoperatively. Commercial bundles for TKA typically vary between $18,000 and $27,000. Thus, there is a significant amount of difference between the hospital reimbursement, the Hospital Outpatient Prospective System rate and the ASC base rate for a TKA. Unless a significant number of TKAs with good outcomes at a low cost are ensured, I am not convinced Medicare outpatient ASC TKA is going to become popular among surgeons who have an ownership interest in ASCs. However, bundled payment commercially based outpatient TKA will continue to increase due to the improved profitability and desirability of providing this procedure in optimized patients.