Home Health Care

APRIL 15, 2024

Last week, the Centers for Medicare & Medicaid Services (CMS) Innovation Center announced a new proposed model that will undoubtedly affect home health providers, and also allow them the opportunity to get more involved in value-based care initiatives. TEAM would be yet another model furthering that goal, if enacted.

Accountability 79

Accountability Medicare Home Care Quality of Care 79

HIT Consultant

APRIL 1, 2024

Improperly billed for services: The government alleges that TRG billed Medicare for radiology services performed by a radiologist located in the UK, which violates program regulations. The allegations against TRG raise concerns about the quality of care patients may have received and the potential misuse of federal healthcare funds.

Quality of Care 97

Quality of Care Regulations Federal Healthcare Healthcare Providers 97

Home Health Care

NOVEMBER 7, 2021

Centers for Medicare & Medicaid Services (CMS) is that the model will now begin Jan. more room to breathe, Valerie Cornett, chief of strategy and innovation at MAC Legacy, told Home Health Care News. BKD is a Springfield, Missouri-based accounting services firm that provides billing and revenue cycle outsourcing services.

Medicare 105

Medicare Performance improvement Medicaid Quality of Care 105

Briggs Healthcare

JUNE 21, 2023

Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare The Medicare Payment Advisory Commission (MedPAC) has released its June 2023 Report to the Congress: Medicare and the Health Care Delivery System. You may go to our website at www.medpac.gov to view the 10 chapters of the report, or follow the links below.

Medicare 52

Medicare Rehabilitation Accountability Quality of Care 52

p3care

FEBRUARY 10, 2021

From the next performance year (2021), Accountable Care Organizations (ACOs) expect different reporting requirements under the Medicare Shared Savings Program. CMS (Centers for Medicare and Medicaid Services) has recommended changes for ACO reporting criteria. Compact MIPS Quality Measure Set.

Medicare 246

Medicare Accountable Care Accountability Medicaid 246

Home Health Care

SEPTEMBER 3, 2022

Seniors on Medicare Advantage health plans may not always be receiving high quality care, a new study shows. The study’s authors concluded that paying higher premiums is not always necessary when seniors are trying to receive high quality care from an MA plan.

Medicare 118

Medicare Quality of Care Accountability Medicaid 118

Sheppard Health Law

OCTOBER 27, 2021

On October 20, 2021, the Centers for Medicare and Medicaid (“ CMS ”) Innovation Center (“ Innovation Center ”) published a white paper detailing its vision for the next ten years: a health system that achieves equitable outcomes through high quality, affordable, person-centered care.

Medicaid 52

Medicaid Medicare Accountable Care Accountability 52

p3care

NOVEMBER 12, 2021

ACO or Accountable Care Organization is a group of doctors, hospitals, medical centers, and other healthcare providers. This unit works together to care for and look after a patient’s health. Their main goal is to improve the quality of care for patients. Primary care doctors and specialists. Accountability.

Doctors 130

Doctors Accountability Healthcare Providers Accountable Care 130

p3care

NOVEMBER 12, 2021

ACO or Accountable Care Organization is a group of doctors, hospitals, medical centers, and other healthcare providers. This unit works together to care for and look after a patient’s health. Their main goal is to improve the quality of care for patients. Primary care doctors and specialists. Accountability.

Doctors 130

Doctors Accountability Healthcare Providers Accountable Care 130

Home Health Care

OCTOBER 18, 2022

million in order to resolve allegations that it paid physicians to induce referrals of patients that led to false claims to the Medicare and TRICARE programs. Offering illegal financial incentives to physicians in return for patient referrals undermines the integrity of our health care system,” U.S. Gray said in the statement.

Tricare 105

Tricare Medicaid Medicare Integration 105

Home Health Care

AUGUST 25, 2021

Centers for Medicare & Medicaid Services (CMS) is sure to add more fuel to the fire for the “Choose Home” initiative and other movements aiming to bring more care into the home. 31, 2020, accounting for the majority of the COVID-19 pandemic in the U.S. The study period was between March 1, 2020, and Dec.

Nursing 110

Nursing Home Care Medicare Accountability 110

p3care

JUNE 13, 2023

MIPS represents a framework for providers’ accountability and their part in promoting standardized care. So, how have you planned to even out the positive adjustments on your Medicare claims this year? Now, considering the upcoming cuts to Medicare revenues, it becomes worth putting in extra effort.

Medicare 130

Medicare Quality of Care Accountability Integration 130

Home Health Care

APRIL 23, 2024

This article is a part of your HHCN+ Membership On Tuesday, Centers for Medicare & Medicaid Services (CMS) officials vehemently backed the thought process behind the “80-20” wage mandate in home- and community-based services (HCBS). Providers and advocates, on the other hand, continued to argue that the policy could be disastrous.

Home Care 110

Home Care Medicaid Law Firms Quality of Care 110

p3care

OCTOBER 30, 2020

CMS (The Centers for Medicare and Medicaid Services) released the proposed rule for QPP MIPS 2021 via the Medicare Physician Fee Schedule (PFS) Notice of Proposed Rulemaking (NPRM). How MIPS consultants take care of the administrative data to report to the authorities affects revenue cycles. Quality Category: Weighs 50%.

Medicare 243

Medicare Measurable Quality Medicaid Accountable Care 243

Lexis Nexis

OCTOBER 31, 2023

For payers, the opportunity is significant: well-designed online tools translate into better member engagement, higher retention rates, improved health outcomes and quality of care scores, and reduced administrative costs. Make the portal easy to use, and you’ll see members create accounts, login, and return again and again.

Healthcare 52

Healthcare Quality of Care Accountability Medicare 52

Home Health Care

APRIL 27, 2023

Over the last decade, Putman — now CEO of Continuous — has relied heavily on building strong relationships with payers, accountable care organizations (ACOs) and care management companies. When Putman started, the revenue breakdown was about 60% Medicare and 40% managed care. We just tried to keep doors open.

Home Care 91

Home Care Physical Therapy Medicare Accountable Care 91

HIT Consultant

SEPTEMBER 14, 2023

By one estimate, healthcare improvements accounted for one-third of the economic growth of developed nations over the last century. However, actual medical care accounts for 20% or less of what affects population health. By comparing quality-of-care data with population, income, and ethnicity across the U.S.,

Health Data 115

Health Data Telemedicine Accountability Population Health 115

NASHP

MARCH 22, 2024

States are hoping to achieve a number of goals with their MLTSS programs, including increasing access to home and community-based services, promoting care coordination, enhancing quality and beneficiary satisfaction, and mitigating cost growth.

Medicaid 76

Medicaid Nursing Medicare Integration 76

HIT Consultant

OCTOBER 18, 2023

Hilton Hudson, MD, FACS, and CEO of HPC International In May 2022, a California doctor was sentenced to nearly eight years in prison for his involvement in a $12 million Medicare fraud scheme. million in reimbursements from Medicare over a three-year period. He received $4.5

Regulations 105

Regulations Accountable Care Prevention Medicare 105

HIT Consultant

MAY 2, 2023

Andy Auerbach, Chief Revenue Officer of SafeRide Health As the healthcare industry continues to evolve, there is a growing need for innovative solutions that not only improve the quality of care but also make care more accessible. adults without access to a vehicle or public transportation skipped needed medical care last year.

Medicaid 96

Medicaid Regulations Medicare Integration 96

NASHP

JANUARY 12, 2024

In 2024, people with Medicare and Medicaid coverage (i.e., dual eligibles) will continue to enroll in integrated managed care special needs plans or D-SNPs (Dual-Eligible Special Needs Plans). million annual appropriation for interagency collaboration on long-term care integrity and oversight.

Medicaid 65

Medicaid Nursing Accountability Integration 65

Home Health Care

JULY 5, 2022

Hospital readmissions are regularly viewed as an indicator of the quality of care patients receive. The Centers for Medicare & Medicaid Services (CMS) calculates annual readmission rates, and if those rates are higher than national averages, hospitals are financially penalized.

Hospitals 105

Hospitals Primary Care Nursing Quality of Care 105

Healthcare ECONOMIST

DECEMBER 19, 2023

Moreover, the magnitude of the change in patient outcomes should be consistent with the predicted change in hospital quality induced by a closure (forecast unbiasedness). Changes in quality of care after hospital mergers and acquisitions. Methodology An overview of the Chandra et al. New England Journal of Medicine.

Hospitals 72

Hospitals Quality of Care Accountability Medicare 72

HIT Consultant

MARCH 28, 2023

It’s a question that has significant implications for quality of care as well as cost. The High Cost of Poor Behavioral Healthcare A recent study indicates 10% of patients account for 70% of the nation’s costs and that more than half of these patients have a diagnosed mental health disorder.

Quality of Care 98

Quality of Care Population Health Hospitals Medicaid 98

HIT Consultant

MARCH 18, 2022

What You Should Know: – The 32BJ Health Fund, a self-insured fund that provides care for 32BJ SEIU members and their dependents, today released a report that lays bare the stark price disparities between Medicare and private hospitals, and outlines solutions to both reins in prices and holds hospital systems accountable for these practices.

Hospitals 52

Hospitals Medicare Accountability Quality of Care 52

HIT Consultant

FEBRUARY 13, 2023

Tom Wriggins, Principal Industry Advisor at SAS John Maynard, CPA, CFE, AHFI Principal Solutions Architect at SAS In 2022, the Center for Medicare and Medicaid Services (CMS) established health equity as a pillar of its future work. Health outcomes and Medicaid program integrity Health outcomes are a function of the quality of care.

Patient Safety 52

Patient Safety Medicaid Integration Medicare 52

Briggs Healthcare

MARCH 20, 2023

and Jonathan Blum, Centers for Medicare & Medicaid Services – names you may recognize from CMS National Stakeholder Calls. As the nation’s largest payer for health care, the Centers for Medicare & Medicaid Services’ (CMS) mission in our National Quality Strategy includes ensuring everyone is safe when they receive care.

Patient Safety 40

Patient Safety Medicaid Medicare Quality of Care 40

HIT Consultant

OCTOBER 20, 2023

According to a study in the Journal of the American Geriatric Society , non-fatal falls cost an estimated $50 billion in medical expenses, while fatal falls account for an estimated $754 million. can be attributed to falls, including approximately six percent of Medicare and eight percent of Medicaid expenditures. Previously Dr.

Rehabilitation 105

Rehabilitation Pharmaceuticals Prevention Biotechnology 105

Briggs Healthcare

JUNE 28, 2023

Ownership data comes from the Provider Enrollment, Chain, and Ownership System (PECOS), the electronic Medicare enrollment system and national data repository for individual and organizational providers who have enrolled or are enrolling in Medicare.

Nursing 52

Nursing Home Care Measurable Quality Medicare 52

Briggs Healthcare

MARCH 2, 2022

The purpose of this primer is to provide updated information to the patient safety community about the challenges of ensuring the safe care of older adults in Medicare and Medicaid certified nursing homes (NHs) associated with the COVID-19 pandemic, and the federal and state efforts taken to mitigate these challenges.

Nursing 98

Nursing Patient Safety Quality of Care Regulations 98

Health Populi

JULY 13, 2020

The EIU VBHC framework addresses four aspects of how technology can underpin value-based care: Ensuring standardization. Driving efficiency and accountability. The Medicare Trust Fund is financed by payroll taxes, general tax revenue, and the premiums enrollees pay. Capturing and sharing interoperable and transparent data.

Primary Care 106

Primary Care Medicare Accountability Hospitals 106

Briggs Healthcare

MARCH 10, 2022

nursing homes failed to meet the total care staff threshold (4.10 Contract staff accounted for 7.1% LTCCC’s Q3 2021 report can help the public, media, and policymakers identify and assess the extent to which nursing homes in their communities provided sufficient staffing to meet basic clinical and quality of life needs.

Nursing 52

Nursing Quality of Care Accountability Regulations 52

Etactics

JANUARY 26, 2024

Quality of care. These include capitation, value-based reimbursement, and episodes of care/bundled payments. It is also a term applied to traditional Medicare. This helps distinguish it from Medicare managed-care plans, as well as any other new payment systems there might be. Cost containment.

Healthcare 52

Healthcare Primary Care Medicare Healthcare Providers 52

Healthcare ECONOMIST

OCTOBER 4, 2021

The Government Accountability Office (GAO) last week published a report evaluating the Merit-based Incentive Payment System (MIPS). MIPS is an approach for CMS to pay physicians caring for Medicare beneficiaries based not just on volume but on value. How did Medicare physicians fare on the MIPS program? Bonus points.

Medicare 86

Medicare Quality Improvement Quality of Care Accountability 86

Healthcare ECONOMIST

JULY 18, 2022

The Oncology Care Model (OCM) is dead. The Oncology Care Model was a voluntary, alternative payment model (APM), that “ included financial and performance accountability for episodes of care surrounding chemotherapy administration to cancer patients.

Medicaid 81

Medicaid Quality of Care Accountability Patient Experience 81

Sequence Health

DECEMBER 12, 2021

Put simply, patient satisfaction is a measure of how pleased or happy a patient is with their care. It’s important to note that it’s not just about the quality of care provided (although that’s certainly part of it); patients can be happy with their care even if they don’t feel like they received perfect treatment.

Hospitals 52

Hospitals Quality of Care Accountability Patient Experience 52

Etactics

JANUARY 31, 2024

Not much later down the line, value-based care threw itself into the mix. Implemented in the late 1960s, value-based care was a solution to the rising healthcare costs and reduced quality of care. This is because there’s more accountability placed on healthcare providers for patient outcomes.

Quality of Care 52

Quality of Care Doctors Healthcare Providers Healthcare 52