Relias

FEBRUARY 28, 2025

Key sources of IHS funding The IHS is primarily funded by federal appropriations, along with grants, Medicaid and Medicare reimbursements, and third-party billing. Medicaid and Medicare reimbursements Tribal health programs can enroll as Medicaid and Medicare providers to receive reimbursements for eligible services.

Healthcare 52

Healthcare Medicare Medicaid Substance Abuse 52

Relias

JANUARY 11, 2023

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. By 2005, the Centers for Medicare and Medicaid Services (CMS) began piloting value-based care programs that linked payment to quality measures.

Medicare 52

Medicare Healthcare Medicaid Hospitals 52

Relias

DECEMBER 8, 2022

Every year, the Centers for Medicare and Medicaid Services (CMS) releases the Program for Evaluating Payment Patterns Electronic Report (PEPPER). Long‐term acute care hospitals. Partial hospitalization programs. Short-term acute care hospitals. Critical access hospitals. Home health agencies.

Medicare 52

Medicare Hospice Rehabilitation Hospitals 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). Pay attention to your record on patients having urgent, unplanned emergency room visits or hospital readmissions within the first 60 days of care by your agency. The obvious goal here is avoiding patient harm.

Medicare 52

Medicare Hospitals Medicaid Healthcare 52

Relias

MARCH 15, 2022

Hospitals are looking to deliver better customer service with reduced costs, and access to advanced technology without major investments. Hospitals that successfully outsource revenue cycle functions have found that training is the answer. Hospitals need honesty from vendors about the kind of claims that they should be outsourcing.

Hospitals 52

Hospitals Healthcare Medicaid Consultation 52

Relias

JANUARY 8, 2024

The relationship between patient satisfaction scores, reimbursement, and health outcomes The Centers for Medicare and Medicaid Services’ (CMS) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scoring helps hospitals and governing bodies evaluate patient satisfaction through quantitative measurements.

Healthcare 52

Healthcare Medicare Hospitals Clinic 52

Relias

AUGUST 15, 2022

Centers for Medicare and Medicaid Services (CMS) proposes a decrease in Medicare reimbursement for home health agencies by 4.2% To smooth year-to-year changes in the hospital wage index, CMS proposes a 5% cap on negative wage index changes for home health agencies, regardless of the underlying reason for the decrease.

Medicare 52

Medicare Telehealth Hospice Medicaid 52

Relias

APRIL 18, 2022

Reducing the number of hospital- or facility-acquired pressure injuries, which are nonreimbursable. Reducing hospital readmission rates by consistently attending to risk factors. Of course, CMS will not reimburse for costs associated with hospital- or facility-acquired pressure injuries. Reduce Hospital Readmissions.

Medicare 52

Medicare Clinic Hospitals Medicaid 52

Relias

APRIL 28, 2022

Throughout the cycle, the possibility of errors looms if your staff isn’t up to speed on the complex coding demands and rules set by hospitals, insurers, and the Centers for Medicare and Medicaid Services. How Clinical Documentation Integrity Affects Revenue. of claims between 2016 and the third quarter of 2020.

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Clinic Healthcare Medicare Medicaid 52

Relias

JANUARY 30, 2024

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. The data is then tabulated to create the HCAHPS score. The financial impact of HCAHPS scores can be significant.

Healthcare 52

Healthcare Medicare Hospitals Clinic 52

Relias

SEPTEMBER 22, 2023

Care coordinators work in numerous settings including roles in hospitals and outpatient care facilities. 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.

Healthcare 52

Healthcare Communication Medicaid Hospitals 52

Relias

NOVEMBER 16, 2022

In April, the Centers for Medicare and Medicaid Services proposed a $320 million decrease in Medicare payments to skilled nursing facilities for fiscal year 2023. You can provide consistent care if you have accurate documentation of your patient’s care at the hospital. Manage wounds better.

Medicare 10

Medicare Clinic Medicaid Hospitals 10

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. Are they sent to the hospital for evaluation because the agency does not have adequate staff to see the patient that day?

Medicare 52

Medicare Hospitals Medicaid Healthcare 52

Relias

JUNE 1, 2023

However, large technology investments aren’t always realistic in the near term when hospitals and health systems are struggling financially. The percentage is even higher in our heavier Medicaid markets,” said Hermosillo. Some planned revenue cycle software investments aren’t happening right now, but that’s not necessarily a bad thing.

Healthcare 52

Healthcare Administration Medicaid Hospitals 52

Relias

JUNE 1, 2023

However, large technology investments aren’t always realistic in the near term when hospitals and health systems are struggling financially. The percentage is even higher in our heavier Medicaid markets,” said Hermosillo. Some planned revenue cycle software investments aren’t happening right now, but that’s not necessarily a bad thing.

Healthcare 52

Healthcare Administration Medicaid Hospitals 52

Beautiful Voyager

JANUARY 29, 2022

I was entrusted to a mental hospital in Brattleboro, Vermont at age fifteen. This would be the first of many unsuccessful psychiatric hospital stays. I begin looking further into more advanced rehabs, but research has shown me that I couldn’t find one mental rehabilitation center that accepted Medicaid or Medicare in the US.

Mental Health 52

Mental Health Substance Abuse Rehabilitation Medicare 52

Relias

JUNE 1, 2022

Undercoded Complex Hospital Admissions. In the long run, we need a good understanding of exactly what conditions and risk factors and other aspects are affecting hospitalizations and patient care outcomes,” explained Bowman. Yet coding mistakes can mean lost revenue, or worse — fines, compliance, and legal issues.

Clinic 52

Clinic Justice and Corrections Medicare Healthcare 52

Relias

JUNE 1, 2022

Undercoded Complex Hospital Admissions. In the long run, we need a good understanding of exactly what conditions and risk factors and other aspects are affecting hospitalizations and patient care outcomes,” explained Bowman. Yet coding mistakes can mean lost revenue, or worse — fines, compliance, and legal issues.

Clinic 52

Clinic Justice and Corrections Medicare Healthcare 52

Relias

MARCH 12, 2025

Whether its skilled nursing facilities, hospitals, or home health agencies, regulatory bodies require that healthcare providers demonstrate competency in delivering patient care. Competency gaps can lead to adverse events, hospital readmissions, and increased liability risks.

Patient Safety 40

Patient Safety Healthcare Medicare Clinic 40

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. Looking at the Big Picture.

Home Care 52

Home Care Healthcare Hospice Medicare 52

KVC

SEPTEMBER 9, 2024

children are also staying in hospital ERs, hotels, and even out-of-state places, and some are experiencing one-night “emergency” placements in foster homes. It’s not just Kansas; it’s happening in Pennsylvania, North Carolina, Kentucky, Texas, New Mexico, Illinois, Colorado, and more. Across the U.S.,

Foster Care 59

Foster Care Child Welfare Mental Health Welfare 59

Relias

OCTOBER 28, 2022

The Centers for Medicare and Medicaid Services (CMS) is ramping up survey scrutiny for hospice this year, training surveyors to focus on interdisciplinary group care planning and coordination of care as part of an emphasis on meeting four core Conditions of Participation. Increased scrutiny in hospices.

Hospice 52

Hospice Communication Clinic Patient Safety 52

Bipolar Bandit

SEPTEMBER 3, 2021

I can authorize involuntary transfers of patients to hospitals. When patients with serious mental illness are not in jail or hospitalized, crisis can occur anywhere. I evaluate patients at hospital emergency rooms and inpatient medical units. . My job is to make this happen. What do you mean by “mobile”? It’s very common.

Psychiatry 98

Psychiatry Interviewing Psychiatric Schizophrenia 98

Child Welfare Monitor

JULY 22, 2024

.” 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.

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Foster Care Interventional Child Welfare Medicaid 158

Relias

MAY 1, 2022

Because the Centers for Medicare and Medicaid Services will not reimburse healthcare organizations for costs associated with hospital- or facility-acquired pressure injuries, appropriate assessment at the time of admission is vital. Those types of complications from hospital-acquired pressure injuries are linked to almost 60,000 U.S.

Healthcare 98

Healthcare Hospitals Communication Medicare 98

Relias

JANUARY 23, 2023

Our recent study and article aim to bring to light the fact that hospitals need to evaluate their PPD risk assessment process and take appropriate steps to treat patients and provide aftercare in their respective communities. She in fact did have PPD, and sadly, was not treated at all for two years post-delivery.

Depression 98

Depression Patient Safety Mental Health Medicare 98

Social Work Blog

JANUARY 5, 2022

Medicare, Medicaid, TRICARE, Indian Health Service or the Veterans Affairs health system). CSWs who work in settings that provide emergency care (such as hospital emergency departments) where the facility is in-network, but the CSW is OON, are not permitted to balance bill patients beyond in-network cost-sharing amounts.

Clinic 98

Clinic Social Worker Self-harm Psychotherapy 98

Relias

OCTOBER 14, 2022

No hospitals or birth centers offering obstetric care. While still having too few hospitals/birth centers, an increase to over just 60 OB providers per 10,000 births would change a county’s designation from maternity care desert to low-access. This version includes additional information for hospitals and health systems.

Telehealth 52

Telehealth Healthcare Hospitals Patient Safety 52

Social Work Blog

MAY 11, 2023

Safe and effective, COVID-19 vaccines have been shown to prevent severe illness, hospitalization, and death. The Committee’s position has been evolving over the last several months. Learn more about Connect to End COVID-19 by visiting NASW’s website.

Communication 96

Communication Social Worker Human Services Telehealth 96

Relias

FEBRUARY 26, 2024

” The Centers for Medicare and Medicaid Services (CMS) defines care coordination more holistically as “the process of ensuring that the patient’s health needs and preferences for health information and services are met across the continuum of care.”

Telehealth 52

Telehealth Healthcare Communication Hospitals 52

Relias

OCTOBER 10, 2022

Recently, the Centers for Medicare and Medicaid Services’ (CMS) Special Focus Facility Program report listed nursing homes that have not met the CMS’ health care or fire safety standards. Your reports should reflect common issues, like falls or hospital readmissions, and those that might spur complaints, like pressure injuries.

Nursing Home 52

Nursing Home Healthcare Hospice Medicare 52

Relias

MARCH 29, 2024

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.

Healthcare 52

Healthcare Hospitals Medicaid Case Management 52

Relias

OCTOBER 18, 2022

Whereas obstetricians and physicians can intervene when pregnancy complications occur, they typically provide care in hospital settings, creating limitations for patients who may not have access to that level of care. Medicaid covers 43% of all deliveries but only provides 60 days of postpartum coverage. For example, in the U.S.,

Healthcare 52

Healthcare Medicaid University Interviewing 52

Relias

MARCH 13, 2023

For example, a new Hospital Price Transparency Rule came into effect in 2022. Unfortunately, many hospitals are struggling to implement the new standards promptly. Formerly, hospitals did not disclose the price of individual services to patients before they received care. Why are hospitals failing their audits?

Hospitals 52

Hospitals Medicare Healthcare Medicaid 52

Relias

JULY 14, 2022

Hospitals and health systems have targeted their approaches to these issues and others to help reduce complications through adherence to evidence-based clinical protocols and reducing variation in care. Hospitals must also report on their responses to maternal health cases to reveal how equitable and effective they are.

Mental Health 52

Mental Health Patient Safety Healthcare Domestic Violence 52

Relias

JANUARY 16, 2023

“With more care shifting to home health, providers are able to save time and money by answering patient questions from afar and limiting exposure by avoiding coming into a hospital or other care settings.”. The Centers for Medicare and Medicaid Services (CMS) will expand its enforcement actions against poorly-performing facilities.

Healthcare 52

Healthcare Telehealth Medicare Nursing Home 52

Children’s Defense Fund

JANUARY 16, 2025

The study found nearly one in three rural children in Texas depend on Medicaid. More than 239,000 children in Texas small towns rely on Medicaid/CHIP coverage. The nonpartisan policy and research center also discovered nearly one in three children who live in those communities depend on Medicaid/CHIP for health coverage.

Medicaid 59

Medicaid University Healthcare Advocacy 59