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In 2024, outpatient care for elective cardiac and musculoskeletal surgeries is on the rise, driven by Medicare members catching up on postponed procedures. Technological advancements make outpatient surgeries safer and quicker, with smaller incisions and reduced risks. CMS approval for reimbursement of procedures at Ambulatory Surgery Centers (ASC’s) supports this trend. Research shows outpatient settings offer shorter stays, lower complications, and reduced costs. Payers need to update policies and ensure network visibility to navigate this shift. TurningPoint offers evidence-based solutions to optimize care and incentivize quality, but maintaining patient safety is crucial.
Musculoskeletal (MSK) conditions already represent an enormous burden for the healthcare industry, affecting 1 in 2 adults at an estimated cost of $420 billion dollars annually. More troubling still, MSK conditions are on the rise and expected to increase by 115% by 2050, impacting more than 1 billion people. The surge in MSK conditions is multi-faceted, linked to global aging and rising disease rates. Some speculate that the COVID-19 pandemic had a larger impact that previously thought on the MSK system, where a lasting inflammatory response in the form of myalgias and arthralgias are seen in some patients. The need for safe, high-quality MSK condition management is more important than ever, an aim that can be achieved through evidence-based interventions to improve outcomes, reduce healthcare costs, and improve the quality of life for those suffering.
Earlier this month, the New York Times reported on a concerning trend – unnecessary atherectomies are putting patients at an increased risk of amputation. The procedure, used to treat peripheral artery disease, deploys metal blades to remove plaque from artery walls. Its use has nearly doubled in Medicare patients over the last decade, and a significant portion of this volume has shifted to outpatient settings, namely vascular clinics.
TurningPoint Healthcare Solutions, a leader in clinical and technology-enabled condition management, is pleased to announce its recent reaccreditation by the National Committee for Quality Assurance (NCQA) for Utilization Management (UM). Receiving NCQA accreditation for our Utilization Management Program is a testament to TurningPoint’s unwavering dedication to better healthcare outcomes for our clients and their members. This accreditation validates our commitments to evidence-based medicine, provider enablement, and patient-centered care.
