Drug Shortages Persist: An Update for Hospitals and Health Systems

Drug shortages can lead to a variety of complex adjustments in medical treatment that have the potential to jeopardize patient safety and interfere with the quality of care. And they remain a serious public health problem. A 2016 study by the Government Accountability Office (GAO) showed that, while the number of new drug shortages has trended down...
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What are Comparative Billing Reports and Why Should Medical Groups Care?

They might seem innocuous and inconsequential in a medical group's vast sea of paperwork and electronic data, but comparative billing reports (CBRs), administered by the Centers for Medicare and Medicaid Services (CMS) and prepared by a data mining company called eGlobalTech (eGT), are not something to ignore. Medical practices need to know what CB...
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Healthcare Ransomware Attacks Still Rising: What Providers Can Do

The massive transfer of health information during the past decade to online, internet-accessible systems has created a perfect storm of circumstances for the proliferation of cybercrime in the healthcare sector, including an 89 percent increase in reported healthcare ransomware attacks during the past year, a recently published report reveals.Among...
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3.2 Million More Americans Became Uninsured in 2017

The number of uninsured people in the U.S. has been a key topic of health policy discussions for decades and received increased scrutiny with the passage of the Affordable Care Act (ACA) in 2010 and the implementation of its insurance coverage expansions in 2014.The ACA led to celebrated gains in health insurance coverage. It expanded employer-base...
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ONC Releases Draft ‘Trusted Framework’ for Health Information Exchange, Seeks Comments

One of the hallmarks of the 21st Century Cures Act signed into law in 2016 was the creation of a "trusted exchange framework" to support the safe and interoperable exchange of electronic health information among providers and between providers and their patients. The Cures Act charges the Health and Human Services Office of the National Coordinator...
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Specialty Group Works to Boost Physician Well-Being and Satisfaction

A Health Affairs blog article co-authored this past year by 10 prominent health system CEOs describes the problem of physician burnout as a national public health crisis and "a matter of absolute urgency." The numbers support their contention. The Medscape Lifestyle Survey 2017 reveals that 51 percent of physicians report experiencing this energy-d...
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SOC 2 Type II Certification: A Security Imperative for Healthcare BPO Organizations

Last month, MiraMed Global Services received Statement on Standards for Attestation Engagements (SSAE) No. 16 Service Organization Control (SOC) 2 Type II Certification. The certification criteria reviewed and tested the following areas of MiraMed's policies and practices: Infrastructure: The physical and hardware components of a system. Software:...
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A Year of Uncertainty in Healthcare—and a More Resilient 2018

We close the year with a glance back at some of the most significant healthcare developments of 2017. The word of the year in health law and bioethics was "uncertainty," Carmel Schacar and I. Glenn Cohen of Harvard Law School proclaimed on Health Affairs' blog. The same might well be said of the healthcare sector as a whole. The current climate of ...
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Solid Revenue Integrity Strategies Offer Robust ROI

If you are familiar with how the healthcare revenue cycle operates, you should have heard the term "revenue integrity." It's become an industry axiom and many provider organizations understand the value of having a focus on revenue integrity services. Revenue Integrity DefinedIn healthcare, revenue can be defined as the reimbursement made by an ins...
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Tax Bill Healthcare Provision Portends Major Changes

It has been called "a behemoth piece of legislation that could widen American economic inequality while diminishing the power of local communities to marshal relief for vulnerable people." But it has also been hailed as "a comprehensive overhaul . . . [that] will ignite our economy with levels of growth not seen in generations," creating "more jobs...
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Reduce Reimbursement Leakage Through Revenue Capture Audits

In today's healthcare environment, capturing every cent of revenue due to a hospital, health system or physician group is a challenge. With the advent of legislative reform and changes in the systemic healthcare reimbursement structure, such as the evolving Accountable Care Organization model or value-based healthcare strategies, healthcare provide...
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Educate Clinicians and Collaborate to Combat Opioid Addiction: AHA

Citing eye-opening statistics from the American Society of Addiction Medicine indicating 52,404 fatal drug overdoses in 2015, healthcare leaders are calling for a multi-pronged effort in combatting the opioid epidemic in America. In an article in NEJM Catalyst, a publication of the New England Journal of Medicine, Jay Bhatt, DO, and Elisa Arespacoc...
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Cuts to ACA Haven’t Deterred Consumers

Recently, federal funds that assist Americans signing up for health insurance coverage under the Affordable Care Act (ACA) were cut by 40 percent and the ACA advertising budget was slashed from $100 million to $10 million.These moves demonstrate the determination of the current administration and many in Congress to minimize the ACA insurance marke...
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Opioids a National Public Health Emergency: A Presidential Declaration, a Comprehensive Report

Following on the heels of President Trump's declaration of the opioid epidemic as a national public health emergency, the president's commission on the opioid crisis last week issued its final reportcontaining more than 50 recommendations for addressing what has been called the most serious drug problem in U.S. history. The report, the heightened f...
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Consumers Expect More from their Healthcare Experience as Payment Responsibility Rises

​The level of respect, compassion and sensitivity to healthcare consumers is increasingly being used to judge patient satisfaction regarding quality of care and is an important component of a healthcare system's care delivery.There is an increasing focus on encouraging individuals to be more involved in their care, which has prompted providers to d...
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A Refresher for Healthcare Providers on Business Associate Agreements: Are Your Contracts in Order?

Under the HIPAA Omnibus Rule, failure to have written business associate agreements in place can lead to sizable fines and penalties for covered entities. In 2015, for example, Raleigh Orthopaedic Clinic, PA, of North Carolina paid $750,000 to settle charges that it potentially violated the HIPAA Privacy Rule by sharing patient protected health inf...
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Impending Disproportionate-Share Hospital Payment Reductions Threaten Safety-Net Hospitals’ Finances

​Safety-net hospitals rely on disproportionate-share hospital (DSH) payments to help cover uncompensated care costs and underpayments by Medicaid. The Affordable Care Act (ACA) anticipated that insurance expansion would increase safety-net hospitals' revenues and planned to reduce DSH payments accordingly.However, decreases in uncompensated care co...
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Hospitals Take on ‘Food Insecurity’ to Impact Population Health

As healthcare delivery shifts toward population health management, hospitals and health systems are beginning to understand—and take steps to address—the connections between a wide range of socioeconomic factors and the health and well-being of the communities they serve. One of these factors is "food insecurity," which the U.S. Department of Agric...
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Final Two Deadlines Loom for Medicare Quality Payment Program

The Medicare Quality Payment Program (QPP) began on January 1, 2017, and required that eligible physicians and certain non-physician practitioners participate in either the Merit-Based Incentive Payment System (MIPS) or an advanced Alternative Payment Model (APM). MIPS-eligible clinicians who do not participate in either track in 2017 will receive ...
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OIG Zeroes in on Opioid Misuse, Abuse, Diversion and Fraud

Addiction experts report that the opioid epidemic is shifting more to the illicit trade of heroin and fentanyl. However, that doesn't diminish the central role that prescription painkillers continue to play in this public health crisis. Nor does it diminish the responsibility of physicians, nurse practitioners, physician assistants and healthcare f...
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