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The Centers for Medicare & Medicaid Services list of hospital acquired conditions for FY10.
One study suggests that success under the Medicare value-based purchasing program may correlate with higher expenditures on routine services that impact patient satisfaction.
CMS is renewing efforts by its contractors to enforce compliance with signature guidelines.
The HHS Office of Inspector General is focusing on readmissions. Hospitals that have excessive readmissions may see reduced payments under the Hospital Readmissions Reduction Program.
New flu, obesity V codes are among the ICD-9-CM changes for FY11.
The long and winding road toward accountable care has not been without bumps, but accountable care organizations constitute a bona fide, inexorable trend that should pick up steam in the years ahead.
If Congress decides to retain an RBRVS type payment system, it will need to consider whether it wants to modify the SGR in some way rather than remove it entirely.
One organization’s long experience as an accountable care organization shows that accountable care can be successful, not only in improving population health, but also financially.
Brent James, MD, chief quality officer at Intermountain Healthcare, says using data-driven performance improvement grounded in shared values is “just good management.”
The Medicare value-based purchasing (VBP) program is an initiative described in the Affordable Care Act whose purpose is to provide a practical means to reduce costs to the nation’s healthcare system while improving quality of care. Hospitals that achieve the highest total performance scores (TPSs) under this program’s scoring methodology can earn incentive payments for performance excellence.
The Issue The Medicare value based purchasing program is an initiative described in the Affordable Care Act whose purpose is to provide a practical means to reduce costs to the nation’s healthcare system while improving quality of care.
CMS has an active to-do list under the Affordable Care Act (ACA) for implementing its “Pay for Quality” strategy.
The Conditions of Participation for Critical Access Hospitals have specific requirements that bear careful, periodic review to ensure ongoing compliance.
The Medicare Shared Savings Program has created the impetus for accountable care organizations. But financial leaders should heed two important lessons from past integration efforts-and six influential forces-before pursuing an accountable care organization.
States--not CMS--have regulations in place related to timely patient notification of the availability of financial assistance/charity, as well as a statement that includes a summary of charges.
Princeton Healthcare shares the benefits it received from instituting accurate and thorough clinical documentation.
The average cost per discharge was $9,100 for all payers in 2008. Medicare discharges had the highest average cost per hospital stay ($11,300).
Medicare-Medicaid enrollees account for a disproportionately large share of expenditures in both programs, totaling approximately $120 billion in federal and state spending.
Recent pressures from the Medicare RACs and various third-party payers have increased the sense of urgency that hospital leaders feel about getting observation programs established.
Providers may be affected by the retroactive increases in payment rates for claims affected by the Affordable Care Act and 2010 Medicare Physician Fee Schedule changes.
Hospital revenue cycle leaders should prepare for the expansion of the RAC program to include review of Medicaid claims.
A well-written RAC appeal letter can help you win your case and ease the administrative burden of audits.
The July 2011 report by the CMS actuaries contains good news and bad news—depending on one’s perspective.
All those wanting to be part of the Medicare payment by episode demonstration (aka bundled payment), come on down! And bring your data and signatures.
Glenn Hackbarth, chairman of the Medicare Payment Advisory Commission, shares his thoughts about the cost-effectiveness of preventive care initiatives and other issues related to Medicare.
Russ Graney, founder and CEO for Aidin, and John Laursen, head of business development for Aidin, share insights on how to improve care transitions between acute and post-acute care settings and incentivize high-quality patient outcomes.
Scott Elston, strategic accounts manager, GE Healthcare Services, describes how substantial cost reduction in health care requires rethinking business strategy and asset use.
Robert Williams, MD, director, Deloitte Consulting LLP, and Arielle Freiberger, product strategist, ConvergeHEALTH by Deloitte, explain how sophisticated retrospective, real-time, and predictive data analytics can inform decision making to reduce costs and improve care.
Stuart Hanson, director of business development (healthcare solutions) at Citi Retail Services, discusses how improving the payment experience can benefit consumers and healthcare providers.
Scott Schmidt, vice president, Cerner RevWorks, LLC, shares insights on best practices for maximizing a revenue cycle management partnership.
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