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Welcome to the Fall edition of the Leading Edge.

In our first article, we highlight the recommendation to remove total knee surgery from in-patient only. Next we highlight AAAHC recommendations on colonoscopy best practices.

Then we have a piece on the trend for more Ambulatory Surgery for Breast Cancer.

The next article summarizes what everyone in the ASC world knows: moving procedures to the ASC from a HOPD reduces costs without impacting quality or outcomes.

Our feature articles begin with a look at telemedicine: is it at a “tipping point?” Many think so despite the barriers that remain.

Next we look at Medicare Advantage. This below-the-radar version of Medicare insures nearly a third of Medicare patients in what otherwise look like commercial plans. But increasingly, we see MA adopting narrow networks.

Healthcare exchanges are highlighted in our next feature. Everyone has seen the news about insurers dropping out. But exchanges aren’t going away so expect to see more narrow networks and expanded efforts to attract younger and healthier consumers.

In our final feature, we describe current industry efforts to improve population health. It is clear that managing a population’s health is hard but we are beginning to see early success stories.

In the Compliance Corner, you will learn why OIG exclusion checking is so important and about a new AdvantEdge offer that can assist you with exclusion testing.

You can print any article in this newsletter as a PDF and there is a PDF “button” to download the entire newsletter for email or printing.

A last, personal, note. This is my last issue of the LeadingEdge. I am retiring in October. But rest assured that the LeadingEdge and the other AdvantEdge newsletters are in good hands. Hannah Paoletti does most of the heavy lifting and Mike Krivich is on board to take over my end of things. I’m sure the quality of articles will continue to improve, which has always been our objective.

We appreciate your feedback and suggestions. Please call or email Mike with comments and topics: and (630) 874-2545.


Bill Gilbert