Study Shows How to Meet the Needs of Complex High-Need Patients

Hospitals and health systems can make a more meaningful dent in the costs of care and improve the value of the care they deliver by zeroing in on the social and behavioral health needs of their most complex high-need patients, according to a new report published by The Commonwealth Fund.The problem isn't that these individuals lack access to medica...
Continue reading
0 Comments

Veterans Affairs Issues Final Rule Expanding Practice Authority

On December 14, the Department of Veterans Affairs (VA) published a final rule amending its medical regulations to expand the scope of practice for certain Advanced-Practice Registered Nurses (APRNs) at VA facilities. The VA believes the rule, which becomes effective January 14, 2017, will make it easier for veterans to be seen by medical professio...
Continue reading
0 Comments

2016 Healthcare Year in Review

The spotlight on the healthcare industry grows brighter every day. The industry is facing immense scrutiny on every aspect of the clinical and business drivers. Healthcare delivery is morphing from a fragmented multi-organizational industry to a more consolidated business structure where major players are merging or acquiring smaller entities. This...
Continue reading
0 Comments

Ensuring Access to Care in Urban and Rural Communities

A report from the American Hospital Association (AHA) outlines emerging strategies to help hospitals in rural and urban communities strengthen their viability in the current environment and preserve their ability to deliver services to vulnerable populations.Developed by a 29-member task force of hospital and health system leaders and state hospita...
Continue reading
0 Comments

Settlement Offer Announced for Appealed Medicare Claims

Review of Appeals Process and Current BacklogMedicare Administrative Contractors process an estimated 1.2 billion fee-for-service claims each year on behalf of the Centers for Medicare & Medicaid Services (CMS) for more than 33.9 million Medicare beneficiaries. Of the 1.2 billion claims filed in 2015, 123 million or about 10 percent were denied...
Continue reading
0 Comments

Separating Fact from Fiction in Healthcare Medical Chart Auditing

Chart auditing programs have become more important in light of increased federal payer audits. As a result, many providers want assurances that their medical chart documentation is accurate and is descriptive of the provided medical services. Validating processes and functions in a healthcare setting follows the same principles as fact checking a n...
Continue reading
0 Comments

A Timely, Transparent Response to Unexpected Harmful Events

"We realize mistakes happen, and we can forgive that," says patient advocate Carol Hemmelgarn, whose nine-year-old daughter died of medical error and a hospital-acquired infection (HAI) in a teaching hospital. "But you harm us again by not being honest and transparent with us . . . we should be healing and learning together how to prevent this from...
Continue reading
0 Comments

Data Released on Medicare Bonuses

WikiLeaks: The Hacker's HackerAccording to federal data released November 1, more than 1,600 hospitals will see bonuses from Medicare in 2017 under the Hospital Value-Based Purchasing (VBP) Program; about 200 fewer than last year.Program BackgroundThe Hospital VBP Program was established under the Affordable Care Act in 2012 as one of many initiati...
Continue reading
0 Comments

WikiLeaks, Hackers and Cybercriminals Keep Healthcare IT Stakeholders on Guard

WikiLeaks: The Hacker's HackerYou would have to be living completely off the grid to be unfamiliar with WikiLeaks, the multi-national media organization founded by Julian Assange. WikiLeaks has elevated itself as the most well-known name in hacking, exposing classified, censored or otherwise restricted official materials involving war, spying and c...
Continue reading
0 Comments

The Essentials of Emergency Preparedness

In slightly less than a year (by November 15, 2017), healthcare entities that participate in Medicare and Medicaid will be required to meet the provisions of the Centers for Medicare & Medicaid Services' emergency preparedness final rule.In a recent webinar hosted by Hospitals & Health Networks, Regina Phelps, founder of Emergency Managemen...
Continue reading
0 Comments

Final MACRA Rule Released by CMS

In an e-Alert released last month, we noted that the Centers for Medicare and Medicaid Services (CMS) would soon be issuing a final rule relating to the Medicare Access and CHIP Reauthorization Act (MACRA). That final rule was issued this past Friday, and includes changes and clarifications responsive to over 4,000 public comments."This is a landma...
Continue reading
0 Comments

Deconstructing Healthcare Consumerism

Consumerism and Personal Debt AccumulationMerriam-Webster defines consumerism as the promotion of the consumer's interests and it states that an increasing consumption of goods is economically desirable. The United States has become a society of increasing consumerism, where individuals are making increasing levels of purchases for a variety of con...
Continue reading
0 Comments

A Framework for Tackling Health Disparities

SummaryIn the introduction to its new white paper, Achieving Health Equity: A Guide for Health Care Organizations, the Institute for Healthcare Improvement (IHI) tells the story of Tommy Cannon, a black American with type 2 diabetes and no access to preventive healthcare, who died in 1973 at the age of 62. Cannon waited hours in a segregated physic...
Continue reading
0 Comments

Emergency Preparedness Requirements Finalized for Healthcare Facilities

SummaryEarlier this month, the Centers for Medicare & Medicaid Services (CMS) finalized a rule to establish consistent emergency preparedness requirements for healthcare providers participating in Medicare and Medicaid, increase patient safety during emergencies and establish a more coordinated response to natural and man-made disasters. Health...
Continue reading
0 Comments

MACRA Flexibility: Set Your Own Pace in 2017

The clinician community breathed at least a partial sigh of relief last week. The Centers for Medicare and Medicaid Services (CMS) announced that clinicians would not suffer financial penalties in 2019 based on their performance in 2017 under the new Quality Payment Program (QPP) that implements the Medicare Access and CHIP Reauthorization Act (MAC...
Continue reading
0 Comments

Improving Patient Satisfaction with Texting

The Rise of Text Messaging in AmericaOn June 19, 1934, President Franklin D. Roosevelt signed the Communications Act of 1934 into law.1 This Act established the Federal Communications Commission (FCC) agency that regulates all interstate and foreign communication by wire and radio, telegraphy, telephone and broadcasts such as Short Message Service ...
Continue reading
0 Comments

Engage Front-Line Clinicians to Drive Down the Costs of Care

The Centers for Medicare and Medicaid Services' 2018 target date for having 50 percent of all Medicare fee-for-service payments made through a value-based model is not far away. The transition to value requires hospitals, physicians and post-acute care providers to unite in delivering a high quality and cost-effective patient experience. Indeed, pr...
Continue reading
0 Comments

Quantros Study Finds No Correlation Between CMS Star Ratings and Quality

As we reported in an earlier briefing, the Centers for Medicare and Medicaid Services (CMS) published hospital quality star ratings on July 27th, despite pressure from industry stakeholders and Congress to delay their release. The ratings are a composite metric of one to five stars, with five being the best. They intend to convey the overall qualit...
Continue reading
0 Comments

Three Research Studies Indicate Early Discharge Puts Patient Lives at Risk

Today hospitals operate under a microscope. Consumerism has motivated healthcare leaders to become more transparent in publically sharing their pricing, quality and performance data. In addition, they must comply with a barrage of new reporting requirements thrust upon them by governmental mandates. These trends along with other operational challen...
Continue reading
0 Comments

How Hospitals Can Avoid the Risks of Moving to the Cloud

Eighty-three percent of healthcare organizations have systems in a cloud environment, and an additional nine percent are in the planning phase, according to a 2014 survey by the Health Information Management Systems Society (HIMSS). Other research shows that 55 percent of hospitals have already migrated mission-critical and sensitive data to a clou...
Continue reading
0 Comments

Sign up for our eAlerts and Newsletters

 

 

Family of Companies Video

 

Please sign up to receive our communications. We offer weekly healthcare-specific eAlerts and MiraMed Focus, our quarterly healthcare journal featuring articles by experts in the healthcare industry.

 

 

Sign Up Now!