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MiraMed’s eAlerts are distributed via email every Wednesday, and contains the latest industry information regarding business process outsourcing solutions, helpful coding news, or any number of relevant topics in the fast-paced, ever-evolving world of healthcare. To subscribe, simply complete the form below. Below the subscription form, you will find the archived eAlerts available.

August 10, 2016

Anyone who has followed the healthcare industry over the past few years understands the transition that is underway moving from the traditional fee-for-service (FFS) model of reimbursing providers for delivering care where physicians and organizations are incentivized to do more and provide more services.  Under this economic model, a provider can make more money by ordering more tests, see more patients and perform more procedures.

Read more: Improving the Patient Experience Drives Superior Patient Satisfaction

August 3, 2016

Health plans and care providers need to open the lines of communication with each other in ways that they have never done before.  In order to maintain compliance and receive accurate payment from the Centers for Medicare and Medicaid Services (CMS) that reflects the severity of illness, utilization of resources and the increasing number of chronic conditions requires ongoing management of care documentation by providers.  The silos that exist between payers, providers and other enterprises must play ball together, or they will become their own besetting evil.  Frankly, this decision to communicate and collaborate will be the very process that will separate the “Men from the Boys; and the Women from the Girls.”  This article will delve into four areas that affect improper payments and will offer strategies to mitigate them.  They are:

Read more: Where the Rubber Meets the Road – Correcting Improper Payments

July 27, 2016

As part of their continuing efforts to make quality of care information more readily available, the Centers for Medicare & Medicaid Services (CMS) has developed a rating system that reflects comprehensive quality information about the care provided at our nation’s hospitals.  The ratings are intended to convey a hospital's overall quality with a single, composite metric of one to five stars, with five being the best.  The CMS originally planned to publish those ratings on its Hospital Compare website in April but delayed doing so after 60 senators and 225 representatives wrote letters urging it to hold off.  The CMS already publishes hospital star ratings based on patient experience; however, the Overall Hospital Quality Star Rating (Star Rating), which was developed through a public and transparent process, takes 62 existing quality measures already reported on the Hospital Compare website and summarizes them into a unified rating of one to five stars.  The rating includes quality measures for the routine care an individual receives when being treated for heart attacks and pneumonia to quality measures that focus on hospital-acquired infections, such as catheter-associated urinary tract infections.  Key measures included in the Star Rating ask questions such as:

Read more: Overall Hospital Quality Star Ratings

July 20, 2016

According to the U.S. Centers for Disease Control, 44 people die every day in the United States from overdose of prescription painkillers.1  In order to combat the devastating effects of the growing epidemic, the American Hospital Association (AHA) and the Centers for Disease Control (CDC) have joined forces to educate the public about the issue.  With the help of various experts from within the healthcare industry, the organizations formed a document entitled, Prescription Opioids: What You Need to Know, detailing the risks and side effects of opioids.  In light of this release and the current national focus on opioid prescription use and abuse, it is important to understand what facilities and hospital systems can do to assist in curtailing this rapidly growing epidemic.

Read more: The Hospital’s Role in the Opioid Epidemic

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