Digital Strategy for Doctors: ‘Lead or be Left Behind’

The median American uses three of the eight major social media platforms, the Pew Research Center reports. Globally, the number of social media users in 2018 is 3.2 billion, up 13 percent year-on-year, according to Global Digital Report 2018. The continued mushrooming of social media's potential influence indicated by these numbers points to an imp...
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Are Your Business Associate’s Putting You at Greater Risk?

What if your organization had to pay a $1.55 million Health Insurance Portability and Accountability Act (HIPAA) settlement because you did NOT have a Business Associate Agreement (BAA) and/or did not confirm risks were mitigated? Do NOT let this happen to you or your business associate (BA)!In 2011, the Office of Civil Rights (OCR) conducted an in...
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How Patients are Using Online Medical Records: ONC Study

Patients are embracing online access to their medical records, and as healthcare providers adopt new interoperability standards for electronic medical record exchange, patients are also likely to begin using apps to share their records across other devices as well.That is one of the key findings of a 2018 survey of more than 3,100 households conduc...
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Is There a Real Time Advantage to Telemedicine?

Time is money, and nowhere is this truer than in the world of healthcare.One of the advantages of using telemedicine is time savings. Both patients and physicians are utilizing video visits to be more effective and save time. When compared head-to-head with patients who have the same needs, a video proves to be faster than the in-person equivalent....
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2019 Physician Fee Schedule Aims to Reduce Clinician ‘Administrative Burden’

The Centers for Medicare and Medicaid Services (CMS) has published the 2019 Physician Fee Schedule (PFS) final rule detailing, among other things, changes to the Quality Payment Program for Year 3 (payment year 2021), changes to documentation requirements for E&M services, new policy regarding site-neutrality payment, reductions in the 340B dru...
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​Survey Shows Need for More Healthcare 'Data Trust'

How much do you trust the quality of your organization's data as a financial, clinical and operational decision-making tool? How easily and reliably do your current systems enable your organization's various service lines and functions to harness that data and generate meaningful reports for important decision making, without having to go through I...
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OPPS Final Rule to Cut Site-Neutral Payments in Two-Year Phase-In

The final rule for the 2019 Medicare Outpatient Prospective Payment System (OPPS), released on November 2, includes new site-neutral payment policies, changes to the 340B Drug Pricing Program and updates to the Hospital Outpatient Quality Reporting System intended to reduce administrative burden for providers.In response to public comments, the Cen...
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Medicare Advantage Proposed Rule Expands Telehealth Benefits

A proposed rule issued by the Centers for Medicare and Medicaid Services (CMS) would expand telemedicine services for Medicare Advantage (MA) plan enrollees while enhancing the methods used to scrutinize MA program integrity.Among other things, the proposals would implement provisions of the Bipartisan Budget Act of 2018, which enables MA to expand...
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CMS Model to Care for New, Expectant Moms with Opioid Use Disorder

Overcoming obstacles to coordinated, integrated care for pregnant women and new mothers with opioid use disorder (OUD) is the thrust of a new model developed by the CMS Innovation Center that will join "care-delivery partners" with state Medicaid agencies as part of a federal multi-faceted strategy to tackle the opioid epidemic.The initiative, base...
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Are You Ready for the New Joint Commission Ambulatory Care Pain Standards?

In June of this year, The Joint Commission (TJC) released new and revised pain assessment and management standards for all TJC-accredited ambulatory care facilities, critical access hospitals and office-based surgery organizations. These standards are part of TJC's efforts to address disparities between the pain management standards the organizatio...
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Involve Doctors, Caregivers to Improve EHRs: Physician Survey

Health systems could be doing more to help physicians and other members of the care team derive optimal benefit from their electronic health records (EHRs) and other health information technologies, a new survey reports. Among the most important steps organizations can take to make more of their HIT investments are proactively soliciting input from...
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Five New CPT® Codes Support Billing for Telehealth, Remote Monitoring

The American Medical Association (AMA) has introduced new codes in the 2019 Current Procedural Terminology (CPT®) code set that would allow physicians to bill for some remote patient monitoring services and internet consultations.Acceptance of the new codes by the Centers for Medicare and Medicaid Services (CMS) in the 2019 Physician Fee Schedule "...
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Size and Profitability Do Not Go Hand in Hand: Health System Study

A new report throws into question the common wisdom that scale enhances health system operations. The study, by consulting firm Navigant, found no correlation between higher revenues and better operating margins among 104 highly rated hospital systems during 2015-2017, following the expansion in insurance coverage that accompanied the Affordable Ca...
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Mapping the Road to Regulatory Relief

One way to reduce healthcare costs is to reduce the time and resources providers and clinicians are forced to spend complying with the plethora of government healthcare regulations. This is the stance of the American Hospital Association (AHA) and other industry groups, which assert that healthcare organizations and professionals could do a better ...
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Guide Helps Providers Shield Infusion Pumps from Cyberattacks

September 5, 2018The unprecedented connectivity of today's wireless infusion pumps with healthcare systems, networks and other medical devices enhances the efficiency and quality of care. However, that same connectivity exposes healthcare organizations and patients to a slew of new cybersecurity risks. These risks range from access and tampering by...
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Measure Healthcare Equity to Improve Quality: Health Affairs Study

​Healthcare has experienced a meteoric rise in the use of quality measures to determine payment through the Hospital Value-Based Purchasing Program (HVBP), the Merit-Based Incentive Payment System (MIPS) and other programs. An article in Health Affairs argues that what are missing from these programs are measures and payment incentives tied to one ...
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OIG Review Finds $25.8M in Hospital Overpayments for IMRT Planning

A new Office of Inspector General (OIG) audit report indicates that Medicare made as much as $25.8 million in overpayments to hospitals for intensity-modulated radiation therapy (IMRT) planning services during 2013 through 2015.IMRT is an advanced radiation procedure used to treat difficult-to-reach tumors. Payment for the computer-based planning r...
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AHA Outlines Strategies to Stem Medicare Appeals Backlog

August 15, 2018As of June 2017, the Medicare appeals backlog stood at an astonishing 607,402 pending cases at the administrative law judge level. Estimates indicate that it will soar to 950,520 cases by the end of the 2021 fiscal year.To help tackle the overwhelming glut of appeals, a federal judge asked the American Hospital Association (AHA) this...
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Few Patients Use Price Comparison Tools: NBER Study

Despite the fact that most health insurance companies now provide a price transparency tool for beneficiaries, only a tiny minority of patients choose to shop for healthcare services or review provider prices before accessing services, a new study by the National Bureau of Economic Research has found.Researchers analyzed data from a large private i...
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Six Principles for Opioid Prescribing: MGMA Report

When it comes to reducing the risk of opioid abuse and the over-prescribing of opioid medications, medical practices should think in terms of communication, technology and referral management, a new report from the Medical Group Management Association (MGMA) advises.Titled Combating the Opioid Epidemic: Effective Policies and Communication Strategi...
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