Relias

JANUARY 8, 2024

Medicare payment systems link patient satisfaction scores with reimbursement rates, making quality patient care a primary determinant of an organization’s viability and motivating healthcare administrators to implement patient satisfaction strategies. According to the program, hospitals with higher HCAHPS scores earn higher reimbursements.

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Healthcare Medicare Hospitals Clinic 52

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. But as a major difference in how most providers have operated, change has come slowly.

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Medicare Healthcare Medicaid 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). 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.

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Medicare Hospitals Medicaid Healthcare 52

Relias

OCTOBER 7, 2021

Medicare and other payers also encourage home-based care when appropriate to keep the cost of care low compared with skilled nursing facilities and hospitals. Now they are hoping to reduce their risk of infection from COVID-19 and get more consistent care in their homes. Financial Drain From Employee Churn.

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Social Work Blog

APRIL 18, 2022

The Centers for Medicare and Medicaid Services (CMS) has released clarifying information about Part 2 of the No Surprise Act, Good Faith Estimates (GFEs). April 18, 2022. The frequently asked questions (FAQs) answer many of the questions that social workers asked when the No Surprise Act was implemented in January 2022.

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Psychotherapy Medicare Social Worker Nursing Home 95

Relias

AUGUST 15, 2022

Centers for Medicare and Medicaid Services (CMS) proposes a decrease in Medicare reimbursement for home health agencies by 4.2% The act mandates a six-year monitoring period for the Patient-Driven Groupings Model ( PDGM), the home health payment model implemented for Medicare in 2020. Cap on Negative Wage Index.

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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. Chronic wounds affect about 15% of Medicare beneficiaries each year. Reduce Hospital Readmissions. Build Your Reputation as a Specialist.

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Medicare Clinic Hospitals Medicaid 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. A study published in Value in Health on the cost of chronic wound care for Medicare beneficiaries revealed that nearly 15% of the patients (8.2 billion to $96.8

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Medicare Clinic Medicaid Hospitals 10

Relias

SEPTEMBER 23, 2022

The percentage of Medicare hospice beneficiaries dying with a diagnosis of dementia or Parkinson’s disease, some of whom have dementia, has increased from 9% in 2002 to almost 21% in 2019, according to the National Hospice and Palliative Care Organization’s Facts and Figure Report 2021 Edition.

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Hospice Medicare Hospitals Communication 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.

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Healthcare Medicare Hospitals Communication 52

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? million decrease.

Medicare 52

Medicare Hospitals Medicaid Healthcare 52

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.

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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.

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Clinic Social Worker Self-harm Psychotherapy 98

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

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.

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Telehealth Healthcare Hospitals Patient Safety 52

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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.”

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Telehealth Healthcare Communication Hospitals 52

Relias

FEBRUARY 1, 2023

Claim denials cause revenue loss at a time when hospitals are facing a serious financial crisis. That leaves hospitals and medical practices to try to get all the denials overturned. Some Medicare Advantage plans are denying authorization for hospitalization. We communicate the change to the pharmacy team.

Healthcare 10

Healthcare Hospitals Medicare Clinic 10

Relias

JUNE 19, 2023

Since 2016, fewer patients with severe wounds have received care in long-term care hospitals, and more patients have gone to less costly facilities like inpatient rehabilitation and skilled nursing facilities. billion in fiscal year 2016 to $2.01 billion in fiscal year 2018.

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Healthcare Rehabilitation Medicare Clinic 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.

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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.

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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

Swhelper

APRIL 26, 2018

Medicaid provides insurance coverage for a broad array of health services from pregnancy care and childhood immunizations to emergency hospitalizations. One out of every five low-income Americans depends on Medicaid, the national insurance program for the poor jointly run by federal and state governments.

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Medicaid Hospitals Government Medicare 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. Looking at the Big Picture.

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Home Care Hospice Healthcare Medicare 52

Relias

AUGUST 11, 2022

According to the Journal of AHIMA , unresolved claim denials cause an average annual loss of $5 million per hospital. As highlighted in a 2020 Medicare CERT Report , 49% of improper payments were due to missing documentation or coding errors, which equates to revenue loss for the organization as a whole.

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Clinic Medicare Healthcare Administration 52

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.

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Hospice Communication Clinic Patient Safety 52

Relias

JANUARY 16, 2023

This estimate is based on a survey of physicians who primarily serve Medicare fee-for-service and Medicare Advantage patients and represents up to a fourfold increase in the cost of care delivered at home today. The report also found trends in the kinds of services Medicare beneficiaries receive via telehealth.

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Healthcare Telehealth Medicare Nursing Home 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.

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Nursing Home Healthcare Hospice Medicare 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.

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Nursing Home Medicare Medicaid Hospitals 52

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. The new measures included the Birthing-Friendly hospital designation to help reduce maternal mortality and morbidity.

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Hospitals Medicaid Mental Health Medicare 40