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.

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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.

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Hospitals Medicare Healthcare Medicaid 52

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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.

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Healthcare Hospitals Communication Medicare 98

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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.

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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.

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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.

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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.

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Depression Patient Safety Mental Health Medicare 98

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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.”

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Telehealth Healthcare Communication Hospitals 52

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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.

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Medicare Clinic Hospitals Medicaid 52

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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.

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Medicare Hospitals Medicaid Healthcare 52

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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.

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Telehealth Healthcare Hospitals Patient Safety 52

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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.

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Home Care Healthcare Hospice Medicare 52

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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.

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Clinic Justice and Corrections Medicare Healthcare 52

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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.

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Clinic Justice and Corrections Medicare Healthcare 52

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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.

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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.

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Healthcare Telehealth Medicare Nursing Home 52

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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.

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Engagement Healthcare Medicare Communication 52

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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.

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Nursing Home Healthcare Hospice Medicare 52

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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.

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Nursing Home Medicare Medicaid Hospitals 52

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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.

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Clinic Mental Health Domestic Violence Healthcare 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.

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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.

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