In the News: May 18–24

Sg2 is dedicated to helping our clients interpret the latest news and trends in health care. Below you’ll find our analysis of this week’s key industry headlines, along with links to related Sg2 resources.

AMI and CABG Mandatory Bundled Payment Models Start January 1, 2018

The latest final rule from CMS confirms the delayed effective date of regulations pertaining to Medicare’s mandatory bundled payment models and the Cardiac Rehabilitation Incentive Payment Model. The new payment models include Acute Myocardial Infarction (AMI) and Coronary Artery Bypass Graft (CABG) episode payment models for 98 geographic areas, as well as the addition of Surgical Hip and Femur Fracture Treatment (SHFFT) for Comprehensive Care for Joint Replacement (CJR) Model’s 67 geographic areas. These payment models will now begin January 1, 2018.

While CMS has indicated that changes to these models are likely, they also stated that they “disagree with commenters who suggested that CMS withdraw these models altogether and/or delay them indefinitely.” For Sg2’s perspective and an overview of these new cardiovascular payment models, read the Sg2 Expert Insight: No More Guessing: CV Is Next for Mandatory Bundles.

Antibiotic-Resistant Pathogens Are on the Rise

The CDC reports that the multidrug-resistant fungus Candida auris has been linked to 77 cases of infection nationwide, with a predominant occurrence in skilled nursing facilities. A majority of the cases originated in New York and New Jersey, with a handful originating in the Midwest, including Illinois.

The CDC estimates that 2 million people become infected with antibiotic-resistant pathogens each year, resulting in 23,000 deaths. But if you think this is a problem just for infectious disease or your chief quality officer, think again. Read the Sg2 Expert Insight: Antibiotic-Resistant Pathogens: More Than a Bug, Potential Business Chaos to learn the potentially dire financial consequences of infectious diseases for your organization.

Trial Shows Feasibility of HCV-Infected Kidney Transplantation

A pilot trial published in the New England Journal of Medicine has successfully demonstrated that using direct-acting antiviral agents right after transplantation of Hepatitis C virus (HCV) infected kidneys into HCV-negative recipients can quickly cure the disease. The incidence of HCV infection almost tripled between 2010 and 2015, and deaths from drug intoxication from the ongoing opioid crisis have risen, which means there may be an increasing number of kidneys from deceased donors with Hepatitis C; however, with the usage of direct-acting antiviral agents, these kidneys may still be viable for transplantation.

Sg2 believes there will be short-term growth in kidney transplant volumes due to expanding criteria that will increase the kidney supply. See page 16 of the Sg2 report: 2016 Surgery Service Line Forecast to learn more about the change in supply and demand for organ transplants over the next decade.

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As of February 11, 2016, Vizient, Inc. has completed its purchase of MedAssets Sg2 and spend and clinical resource management segments from Pamplona Capital Management, LLC. MedAssets revenue cycle business will continue to operate as a wholly-owned subsidiary of Pamplona Capital Management LLP.

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