Relias

JANUARY 11, 2023

For example, less than 20% of Medicare spending is currently value-based. 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. Why the change to value-based care?

Medicare 52

Medicare Healthcare Medicaid Hospitals 52

Relias

MAY 16, 2025

Reducing hospital readmissions is a critical area of healthcare improvement that can significantly impact both financial standing and patient outcomes. Patients unplanned returns to the hospital after discharge drive up costs, disrupt recovery, and reflect gaps in care.

Recovery 75

Recovery Hospitals Clinic Medicare 75

Relias

NOVEMBER 4, 2021

Keeping an eye on your case mix is important with Medicare reimbursement shifting to value-based purchasing. The Centers for Medicare and Medicaid Services is planning to implement the Home Health Value-Based Purchasing (HHVBP) model nationwide in 2023. Increasing agency profitability.

Medicare 52

Medicare Hospice Healthcare Medicaid 52

Relias

DECEMBER 8, 2022

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). Medicare has identified 10 target areas as risky for proper payments.

Medicare 52

Medicare Hospice Rehabilitation Hospitals 52

Relias

JANUARY 30, 2024

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.

Healthcare 52

Healthcare Medicare Hospitals Clinic 52

Relias

DECEMBER 21, 2021

For Medicare claims, you already track care quality and report it to the Centers for Medicare and Medicaid Services (CMS). Those quality ratings appear on Medicare’s Care Compare website and inform prospective clients how well you’re achieving positive outcomes. Improve Your Quality Ratings. Market Your Successes.

Medicare 52

Medicare Hospitals Medicaid Healthcare 52

Relias

APRIL 28, 2022

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.

Clinic 52

Clinic Healthcare Medicare Medicaid 52

Relias

APRIL 18, 2025

In the ever-evolving world of healthcare, patient experience has emerged as a key indicator of quality care. From improving patient satisfaction to fostering trust, a focus on patient-centered care has become a necessity for healthcare organizations. In healthcare, the experience of the patient is the new marketing.

Healthcare 40

Healthcare Empathy Medicare Medicaid 40

Relias

APRIL 18, 2022

Medicare payment models in skilled nursing and home health provide incentives for clinicians to be well versed in specialty areas such as skin and wound care. Chronic wounds affect about 15% of Medicare beneficiaries each year. Increase Reimbursements Based on Clinical Complexity. Build Your Reputation as a Specialist.

Medicare 52

Medicare Clinic Hospitals Medicaid 52

Relias

MARCH 12, 2025

Regulatory drivers and competency standards Compliance with federal and state regulations is a top priority for healthcare organizations. Whether its skilled nursing facilities, hospitals, or home health agencies, regulatory bodies require that healthcare providers demonstrate competency in delivering patient care.

Patient Safety 40

Patient Safety Healthcare Medicare Clinic 40

Relias

SEPTEMBER 1, 2022

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.

Medicare 52

Medicare Hospitals Medicaid Healthcare 52

Relias

DECEMBER 13, 2021

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.

Home Care 52

Home Care Hospice Healthcare Medicare 52

Relias

JUNE 1, 2022

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.

Clinic 52

Clinic Justice and Corrections Medicare Healthcare 52

Relias

JUNE 1, 2022

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.

Clinic 52

Clinic Justice and Corrections Medicare Healthcare 52

Relias

OCTOBER 28, 2022

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.

Hospice 52

Hospice Communication Clinic Patient Safety 52

Relias

AUGUST 9, 2023

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.

Engagement 52

Engagement Healthcare Medicare Communication 52

Relias

MAY 1, 2022

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.

Healthcare 98

Healthcare Hospitals Communication Medicare 98

Relias

JANUARY 23, 2023

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.

Depression 98

Depression Patient Safety Mental Health Medicare 98

Relias

OCTOBER 14, 2022

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.

Telehealth 52

Telehealth Healthcare Hospitals Patient Safety 52

Relias

OCTOBER 10, 2022

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.

Nursing Home 52

Nursing Home Healthcare Hospice Medicare 52

Relias

FEBRUARY 26, 2024

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.”

Telehealth 52

Telehealth Healthcare Communication Hospitals 52

Social Work Blog

DECEMBER 19, 2022

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.

Medicaid 98

Medicaid Advocacy Communication Social Worker 98

Relias

JANUARY 16, 2023

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. Department and Human Services found that Medicare visits conducted through telehealth in 2020 increased 63-fold, from about 840,000 in 2019 to 52.7 Penalties rise to $1M.

Healthcare 52

Healthcare Telehealth Nursing Home Medicare 52

Relias

MARCH 13, 2023

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.

Hospitals 52

Hospitals Medicare Healthcare Medicaid 52

Relias

MAY 19, 2025

In todays healthcare landscape, few things are certain especially when it comes to the future of Medicare and Medicaid. A proactive focus on healthcare experience is no longer a nice to haveits a strategic imperative.

Medicare 40

Medicare Medicaid Healthcare Recovery 40

Relias

JULY 14, 2023

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.

Clinic 52

Clinic Mental Health Domestic Violence Healthcare 52

Relias

APRIL 6, 2022

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.

Nursing Home 52

Nursing Home Medicare Medicaid Hospitals 52

Social Work Blog

FEBRUARY 3, 2025

Members of our profession also provide frontline services in mental health, substance use treatment, child welfare, and elder care – many of which fall under HHS programs such as Medicaid and the Substance Abuse and Mental Health Services Administration (SAMHSA).

Human Services 91

Human Services Medicaid Substance Abuse Medicare 91

Relias

JULY 20, 2023

­The Centers for Medicare and Medicaid Services (CMS) issued a final rule in August 2022 to improve maternal health outcomes and advance health equity — two of the Biden-Harris Administration’s key priorities. But it’s also important to adopt a holistic view of the maternal healthcare experience. Sadly, U.S.

Hospitals 40

Hospitals Medicaid Mental Health Medicare 40