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Recent Posts
- The False Claims Act and Accurate Documentation
- Nurse-Based vs. BCE Physician-Directed CDI Programs
- RAC Recovery: What a Difference a Fiscal Year Makes
- The Reality of Medicaid and Medicare Cuts Sets In
- HIPAA Alert: increased fines, audits and criminal indictments
- Fraud Enforcement Cases Highlight the Importance of Accurate Documentation
- Texting – Another Potential Way to Violate HIPAA
- Two Initiatives Impacting Current Reimbursement and Bundled Payments
- Released: The Dartmouth Institute’s Report for Opportunities Related to Hospital Acquired Conditions and Readmission Rates
- Problems With Reducing Physician Medicare Payments
Partnership for Patients Ready to Launch
Following up on the April 2011 announcement of the Partnership for Patients program, Congressional Quarterly reported that Health and Human Services officials “put the word out on Thursday [June 23, 2011] that they are reading to begin spending up to $500 million in the Partnership for Patients program designed to prevent hospital injuries and un-necessary readmissions.” The objectives are to reduce adverse hospital events and re-admission rates. Overall, the estimated savings are expected to both reduce Medicare costs and increase savings to Medicare by billions of dollars annually.
Posted on: under: General
Rural Hospital Regulatory Reminders
Rural and critical access hospitals provide a vital service to their communities. Typically, serving as the only source of healthcare. Just because their reimbursement is cost-based and not fee-for-service or quality-based, does not mean exemption from RAC compliance and Program for Evaluating Payment Patterns Electronic Reports (PEPPER) reports. ‣ Read more...
Posted on: under: General
Value Based Purchasing (VBP) Payment Incentive Pool Funded by DRG Reductions
In order to fund the incentive pool that will provide payments for those hospitals that meet or exceed program performance standards for FY 2013, it will be funded through a 1% reduction of participating hospitals’ base operating DRG payments. The percentage increases to 2% in FY 2017. ‣ Read more...
Posted on: under: General
Medicaid to Stop Paying for Hospital Acquired Conditions
Like Medicare, Medicaid will stop paying for nearly two dozen hospital acquired conditions in hospitals. States will have until July 1, 2011 to implement. (76 Fed. Reg. 9283 (Feb. 13, 2011). Twenty-one States currently have a similar policy already in effect. ‣ Read more...
Posted on: under: General
Quality of Care Measures Impact Government and Private Insurance Reimbursement
In May 2011, both the federal government and a private health insurance company released program guidelines to reduce medical costs. WellPoint redesigned its reimbursement model for hospitals that provide service to its BlueCross/BlueShield plans. The new model includes a patient score based on 51 indicators, which measure quality-of-care, patient safety, and patient satisfaction. ‣ Read more...
Posted on: under: General
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