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Private negotiated facility fees at hospitals are on average double the ambulatory surgery center facility fees for common outpatient procedures.Private negotiated facility fees at hospitals are on average double the ambulatory surgery center facility fees for common outpatient procedures.

Medicare Advantage (MA) plans use prior authorization to manage utilization, with denied services appealable through a five‐level process. Independent review entities (IREs) adjudicate second‐level appeals, determining whether initial plan denials were appropriate. This study assessed whether MA plan denials for head and neck cancer surgery are overturned by IREs at higher rates than denials for other services. We analyzed IRE determinations from January 2020 to December 2024, categorizing appeals as head and neck cancer surgery, surgical oncology, all surgery, or all healthcare services. Among 94 head and neck cancer surgery appeals, 11 denials (11.7%) were favorable/partially favorable. This rate was similar to surgical oncology (9.3%; P = .45) but significantly higher than all surgical services (5.6%; P < .001) and all healthcare services (4.5%; P < .001). The most common denial rationale was inadequate documentation. MA plan denials for head and neck oncologic surgery are overturned by IREs at higher rates compared to general healthcare services, which may represent a barrier to time‐sensitive cancer care.

In an effort enhance reimbursement for cognitive specialties, the Centers for Medicare and Medicaid Services (CMS) increased the payment for outpatient and inpatient E&M services in 2021 and 2023, respectively. Notably, visits during the postoperative global period were excluded from this increase. It is well‐established that pediatric subspecialties, including pediatric otolaryngology, are less well‐compensated than their adult counterparts. In this study, we estimated the potential annual revenue increase per academic pediatric otolaryngologist had CMS included global period visits in its revaluation.

While outpatient otolaryngology procedures have been increasingly performed at ambulatory surgery centers (ASCs), the cost differences compared to hospital outpatient departments (HOPDs) remain unclear. Utilizing newly available data collected from Turquoise Health's Rate Sense as required under the Transparency in Coverage rule, we assess, in this cross‐sectional analysis, the differences in negotiated facility fees between ASCs and HOPDs for 20 common otolaryngologic procedures. Analyzing data from 4613 ASCs and 2382 hospitals, we found significantly higher facility fees at HOPDs, with a median relative price difference of +146% (P < .0001). This may be explained by greater infrastructure costs and market power differences between facilities. Our findings suggest that further shifting outpatient otolaryngology procedures toward ASCs could yield substantial cost reductions across health care systems. Additional research is needed to ensure safe and cost‐effective patient selection for ASCs.

More than 90% of FDA-reviewed devices enter the market by means of the 510(k) pathway. In September 2019, the FDA finalized reforms to the pathway. But further steps could better support protection of patients and public health.

Objective Surgical education has undergone major changes in recent years, as hands‐on learning opportunities have been replaced or supplemented with online tools. The goal of this project is to examine the educational impact of a surgical training website, SinusVideos.com, on otolaryngologists at various levels of training. Methods Visitors to the website were asked to complete a survey after viewing a narrated video of a surgical procedure. Surveys were analyzed for demographics, needs assessment, and educational impact. Results A total of 105 completed surveys were completed by 68 (64.8%) attendings/practicing physicians, 32 residents/fellows (30.5%), and 5 medical students (4.8%). Whereas 14.3% of viewers reported online videos as their primary source for surgical preparation, 70.5% considered them important secondary supplements. After viewing a video, 92.4% of respondents reported a gained confidence in performing the surgery, and 62.9% said the video altered how they would perform the surgery in the future. Viewers' ratings of their knowledge (on a 1‐7 Likert scale) of a particular surgical procedure before vs after watching the observed procedure increased significantly for participants at all levels of training—medical students (2.8 before vs 5.4 after, P < .01), residents/fellows (4.8 before vs 5.8 after, P < .0001), and attendings/practicing physicians (5.6 before vs 6.4 after, P < .0001). Conclusion High quality online surgical videos appear to be an effective learning tool for surgical trainees and practicing physicians alike. The educational benefit of such tools, as well as their widespread accessibility, makes them a powerful instrument for the training of surgeons worldwide. Level of Evidence Level 5. Surgical education has undergone major changes in recent years, as hands‐on learning opportunities have been replaced or supplemented with online tools. The goal of this project is to examine the educational impact of a surgical training website, SinusVideos.com, on otolaryngologists at various levels of training. High quality online surgical videos appear to be an effective learning tool for surgical trainees and practicing physicians alike, and the educational benefit of such tools, as well as their widespread accessibility, make them a powerful instrument for the training of surgeons worldwide.

Automatic Medicare Coverage for New Technologies Congress is considering bills that would substantially expand Medicare coverage of certain products. The legislation could undermine CMS’s authority to implement evidence-based coverage policies.