Recommendations for improving utilization review and denial management to reduce LOS
The utilization review and denials management functions play an important role at each transition phase in the acute care process in helping hospitals reduce patients' length of stay in acute care.
Integration supports Presbyterian’s ‘Complete Care’ program
Presbyterian Healthcare Services, based in Albuquerque, is a locally owned, not-for-profit health system of nine hospitals, a statewide health plan and a growing multispecialty medical group. We serve one in three New Mexicans through our healthcare services and insurance coverage. For Presbyterian patients with serious, complex medical needs, we offer a high-touch program that combines primary,…
Around the World in 40 Weeks: Maternity Care Outside the U.S.
Olakunle Olaniyan, MD, MBA, FHFMA, president of Case Management Covenants, discusses what the United States can learn from other countries when it comes to maternity care. Also: an interview with Matt Houston of GHX about adoption of automated payment processes and five fast facts about hospital mergers and acquisitions. Sponsored by GHX.
Address risk factors to bend the cost curve in chronic care
To effectively manage the costs of care for patients with chronic conditions, healthcare organizations should look at social and behavioral factors to identify patients who could benefit from care management.
Specialty practices use predictive analytics to enhance value-based care
Specialty physician practices embarking on value-based care initiatives should start by expanding their ability to collect and synchronize data.
Reconsidering post-acute care options
HFMA President and CEO Joe Fifer highlights the need to consider post-acute care in the context of reducing the total cost of care.
Consolidating Answering Services After Mergers Contains Costs, Increases Physician Satisfaction
Piedmont Healthcare stabilizes costs, improves clinical efficiency, and boost physician satisfaction through careful consolidation of physician answering services.
Health plan data helps physicians, but additional insight would improve outcomes
A patient-centered medical home program has fostered collaborative relationships between a health plan and participating providers, but one provider says the program would be even more effective if the data supplied by the health plan were more actionable.
Connecting with High-Risk Members for Better Care Management
Tara Page-Haddock describes how how care management programs can deliver ROI.
Community Paramedicine Saves Organization $6M in 1 Year
By training paramedics to treat patients at home under a physician’s supervision, Commonwealth Care Alliance is reducing unnecessary emergency department visits and hospitalizations.