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By Denise Johnson, LCSW-C Senior Practice Associate March 2024 In February 2024, a major healthcare cybersecurity attack occurred, affecting many patients and providers including clinical social workers (CSWs). As a result, Change Healthcare became temporarily paralyzed, causing payment disruptions and delays in patient care.
of citizens identifying as American Indian or Alaska Native relied on Medicaid or other public health insurance, and 14.9% on Medicaid or public health insurance and only 6.3% without coverage — Native American healthcare disparities clearly still exist despite efforts to eradicate them. had no coverage at all. with 34.3%
.” It does not define RTF’s, but the term clearly refers to facilities that provide behavioral health services in a residential context to children with funding from programs under SFC jurisdiction, mainly Medicaid and foster care funds under Title IV-E of the Social Security Act.
W hen the National 988 Suicide Prevention Crisis Hotline goes into effect July 16, 2022, it will probably be the most significant public policy initiative impacting behavioral healthcare since the Medicaid expansion. That said, there are those who feel that the states still have a lot to do to be ready for the July 2022 start of 988.
innovations in behavioral healthcare?as Innovations in Behavioral Healthcare and the Path to Digital Transformation. A Case Study of Digital Transformation in Behavioral Healthcare. Paving the Way to Innovations in Behavioral Healthcare. Innovations in Behavioral Healthcare and the Path to Digital Transformation.
In a consumer-driven industry, healthcare organizations must compete to gain new patients and maintain their loyalty. One effective way is to earn high patient satisfaction scores that demonstrate value to customers seeking a trusted healthcare partner.
The Agency for Healthcare Research and Quality calculates that more than 17,000 lawsuits related to pressure injuries are filed each year — second only to wrongful death suits. Understanding the legal implications of gaps in care can help protect all involved: physicians, nurses, other caregivers, and healthcare administrators and leaders.
Clients seeking access to gender-affirming healthcare (including cross-hormone treatment and various surgical procedures) are typically required to get referral letters from mental health professionals. learn tips for advocacy with insurance companies in navigating denials for gender-affirming surgeries.
The Center for Medicare and Medicaid Services (CMS) is seeking feedback from clinical social workers and other providers about how they should provide estimates for costs of services for patients who use their insurance to pay for health and mental health services.
Commonly referred to as Obamacare, this is a moment to reflect on the deep impact this revolutionary legislation has had on the healthcare landscape in the United States. have expanded Medicaid to provide health insurance coverage and health care access to more individuals and families than ever before. Today, 40 states and D.C.
The Centers for Medicare and Medicaid Services (CMS) requires all health facilities in the Medicare program to track and report data reflecting pressure injury development on all clients. The Agency for Healthcare Research and Quality’s patient safety tool, Preventing Pressure Ulcers in Hospitals , also provides helpful guidance.
In our study, we noted that as few as 28% of women with PPD symptoms reported them to a healthcare provider. My colleagues and I work to help improve maternal health outcomes by providing the best education and competency evaluation solutions for the healthcare workforce. on referrals for behavioral health care.
But momentum will continue, since the Centers for Medicare and Medicaid Services (CMS) announced in 2021 that it plans to transition fully to value-based reimbursement by 2030. Healthcare organizations in the U.S. For example, less than 20% of Medicare spending is currently value-based. Why the change to value-based care?
In 2006, California established the California Maternal Quality Care Collaborative (CMQCC), a public-private partnership that brings together healthcare providers, hospitals, health plans, public health agencies, and consumer groups to improve maternal health and reduce disparities. Maternal mortality in the U.S.
Revenue cycle management (RCM) is the financial process that makes it possible for most healthcare organizations to fulfill their mission of providing quality care for patients and communities. RCM is the set of functions that comprise the capture, management, and collection of patient service revenue in a healthcare organization.
They take an active stance in managing the utilization of client healthcare services and in improving client outcomes. The care coordination trend goes by many names and has been seen across the continuum of care but has been most prevalent in the Medicaid world as part of the Health Home model.
February: Dell Children’s Health Plan provides essential healthcare coverage for pregnant mothers, newborns, and children, assisting with Medicaid and other applications to ensure their clients receive necessary healthcare.
Improving patient experience scores is a goal for many healthcare organizations — and for good reason. As they consider new ideas to raise patient satisfaction, healthcare leaders must have an understanding of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scoring system that evaluates these efforts.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), integrated care is defined as “the systematic coordination of general and behavioral healthcare.” To provide the best services possible, healthcare organizations of all kinds must understand how to implement integrated care management.
maternal mortality continues to increase despite the availability of world-class healthcare resources. Along with providing training and resources, they help midwives overcome the distrust of healthcare providers that often surfaces in marginalized populations. In the U.S., million U.S. Department of Health and Human Services.
There’s good news, however — healthcare organizations are finding ways to make low-cost improvements in everything from pre-service processes to post-service collections through revenue cycle optimization. The percentage is even higher in our heavier Medicaid markets,” said Hermosillo. And they are getting results.
There’s good news, however — healthcare organizations are finding ways to make low-cost improvements in everything from pre-service processes to post-service collections through revenue cycle optimization. The percentage is even higher in our heavier Medicaid markets,” said Hermosillo. And they are getting results.
An unintended, but positive offshoot of the pandemic is that the crisis highlighted home health’s “very quick and successful adjustments” and “versatility” to serve COVID-19 patients and millions of others served under Medicare, Medicaid, Veterans Administration, and other services. Increased Compensation.
Training can make all the difference with revenue cycle management outsourcing, healthcare leaders have found. “In Brooks, vice president of revenue cycle at Minneapolis-based Hennepin Healthcare. I tell people all the time: An outsource partner is an extension of your business office,” said Phillip E.
But there is a particular educational tool that tends to fall under the radar of many healthcare organizations. Every year, the Centers for Medicare and Medicaid Services (CMS) releases the Program for Evaluating Payment Patterns Electronic Report (PEPPER). We all love free tools that help our organizations perform better.
For Medicare claims, you already track care quality and report it to the Centers for Medicare and Medicaid Services (CMS). You can bet your referral sources for home healthcare will be paying attention to these risk scores, too. Keep in mind that your referral sources for home health are actively looking at your quality ratings.
According to the Agency for Healthcare Research and Quality (AHRQ), care coordination is “the deliberate organization of patient care activities between two or more participants (including the patient) involved in a patient’s care to facilitate the appropriate delivery of health care services.”
Coding and clinical documentation have never been more important in healthcare. “We At Sharp HealthCare, staff members were doing everything right — they used the correct codes, obtained authorizations, and scheduled services appropriately. Coding is high value — and in high demand. We are seeing sign-on bonuses. Downcoding by Payers.
Coding and clinical documentation have never been more important in healthcare. “We At Sharp HealthCare, staff members were doing everything right — they used the correct codes, obtained authorizations, and scheduled services appropriately. Coding is high value — and in high demand. We are seeing sign-on bonuses. Downcoding by Payers.
The Centers for Medicare and Medicaid Services is planning to implement the Home Health Value-Based Purchasing (HHVBP) model nationwide in 2023. Many healthcare professionals have reported feeling undervalued and underpaid amid the high demands of the COVID-19 pandemic.
Improved care quality and patient safety, reduced readmissions and ER visits, and lower healthcare costs are just some of the positive outcomes of effective care coordination. A well-designed care coordination process benefits patients, providers, and payer organizations. Increased scrutiny in hospices.
For home health agencies, wounds are one of 12 clinical groupings the Centers for Medicare and Medicaid Services (CMS) identifies under the Patient-Driven Groupings Model. More than 17,000 lawsuits related to pressure injuries are filed each year, according to the Agency for Healthcare Research and Quality.
With the successes reaped during the pilot of the Home Health Value-Based Purchasing (HHVBP) program, the Centers for Medicare and Medicaid Services (CMS) aims to accelerate the results nationwide. The program started in 2016 as a pilot to determine the impact of financial incentives on home health agencies in nine states.
Due to inadequate foster care prevention spending on concrete supports like temporary food or housing assistance and a lack of access to mental and physical healthcare, many states far exceed the national rate of children in foster care.
Tis the season for evaluating training programs and checking everything twice to make sure you’re on the Center for Medicare and Medicaid Services’ and The Joint Commission’s nice lists. One robust, magical platform “Platform” is something we hear quite often in IT, and it’s becoming ever more prevalent in healthcare.
A McKinsey & Company survey shows that up to $265 billion worth of care services could shift from traditional healthcare facilities to the home by 2025. The Centers for Medicare and Medicaid Services (CMS) will expand its enforcement actions against poorly-performing facilities. The post 2023 Healthcare Trends: Are You Ready?
Today, Jhpiego is still pursuing its mission of providing reproductive health training and empowering healthcare providers with tools and methods to improve maternal and child health and manage infectious diseases in over 30 countries. Medicaid covers 43% of all deliveries but only provides 60 days of postpartum coverage.
These grim statistics are not news for healthcare organizations. She continues to use her platform to be proactive and make an impact and was named one of the Top 25 Women Leaders in Healthcare Software in 2022 by The Healthcare Technology Report. Maternal Risk Factors: Social Determinants and Mental Health.
In the healthcare industry, regulations and best practices are always changing. The cost of healthcare in America is high, and the price for services can vary widely by region, a patient’s access to insurance, and even by insurance provider. Like other sectors of the economy, the healthcare industry has been affected by high inflation.
However, healthcare providers must consider cases under their care that require medical interventions. maternal mortality data, we see disproportionate numbers of low-income, Black, Hispanic, and other nonmajority identifying patients in geographic areas where access to quality healthcare is less than ideal. In the U.S.
Federal and state agencies’ routine surveys of healthcare organizations can be stressful. With the Biden administration advocating for stricter scrutiny on nursing homes, we know inspection of healthcare facilities may increase even more. Regardless of the healthcare setting, you don’t want to be on this type of list.
Reducing the number of these deaths can be difficult due to social determinants that healthcare providers cannot easily control. More recently, the Centers for Medicare and Medicaid Services (CMS) issued its Maternity Care Action Plan , which also focuses on improving maternal health outcomes and advancing health equity.
New requirements from the Centers for Medicare and Medicaid Services (CMS) announced in November 2021 and a new time-limited enforcement effort by the Occupational Safety and Health Administration (OSHA) announced in March call for focused inspections and put a higher level of scrutiny on nursing home compliance and the quality of care provided.
When the COVID-19 PHE ends, which is expected in 2023, state agencies will begin the “unwinding” of continuous Medicaid and Children’s Health Insurance Program (CHIP) by going through the redetermination process for all enrollees. Unwinding refers to the return to normal operations for Medicaid and CHIP agencies after the COVID-19 PHE ends.
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