When 2020 began, no one anticipated that complying with the Merit-based Incentive Payment System (MIPS)—the flagship payment model of the Centers for Medicare & Medicaid Services (CMS) Quality Payment Program (QPP)—would look so different halfway through the year. Like many other things, the COVID-19 crisis has delayed, diverted, or derailed many organizations’ reporting efforts and capabilities. Lower procedure volumes, new remote work scenarios, and shifting priorities have taken attention
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Billions in Federal Provider Relief Funds Have Been Distributed. Now Come Auditing and Compliance.
Of the $175 billion in federal Provider Relief Funds (PRF) allocated to healthcare providers, $125 billion has been accepted by hospitals and healthcare providers. The cash infusion was designed to cover costs related to COVID-19 related care. These targeted payments were earmarked for preventing, preparing for, and responding to the Coronavirus, solely for reimbursement of healthcare-related expenses or lost revenue directly attributable to COVID-19.
Early on, providers who received PRF
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COVID-19: How Hospitals Can Create Better Inpatient Bed Capacity through Math
Since the beginning of the COVID-19 pandemic, key elements of hospital operations such as managing inpatient bed capacity, and access to ventilators and PPE have taken center stage. The general public got a crash course on what hospitals need in order to function successfully when disaster hits, and daily news and discussions were centered around ICU bed capacity as cases accelerated across the country.
The nightmarish predictions and reality led to the development of creative measures to
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5 Steps for Interoperability Excellence for Healthcare Providers
As if 2020 couldn’t be any more challenging for healthcare providers, new federal rules on interoperability and patient access, granting patients direct access to their healthcare data, begin taking effect in 2021 and will continue into 2022. These rules, while ultimately beneficial to patients, bring an additional level of operational complexity to many revenue-stressed healthcare organizations.
If anything, the 2020 pandemic has illustrated the vast potential of interoperability. For
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5 Myth-Busting New Hospital ADT Notification Requirements
When doctors know their patients have been to the hospital, they can act fast to provide needed support. Widespread use of hospital event notifications is associated with all kinds of health benefits, including a 10 percent decrease in readmissions for Medicare beneficiaries. These event notifications are one of the simplest, easiest (most-bipartisan!), and most impactful changes we can make to improve patient outcomes in U.S. healthcare.
To this goal, the Centers for Medicare and Medicaid
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The Modern Approach to Acquiring Healthcare IT
The COVID-19 pandemic has shed light on the shortcomings of today’s hospital and healthcare IT infrastructure, with many healthcare organizations quickly adopting the latest and greatest technology to support remote operations. However, in the scramble to adapt, many IT leaders did not ensure that the acquired technology integrated well with legacy systems – resulting in underused components and wasted costs. As we enter into a new era in healthcare, it is paramount that these organizations
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Virtual Engagement During COVID Pushes Paradigm Shift for Physician Training and Patient Care
The dominant presence of COVID-19 has not meant the absence of cancer, ear infections, heart attacks, chronic pain, or other illnesses that need attention and care. Physicians have continued treatment for all types of maladies, and physician training has continued as well. But this treatment and this training look much different these days. Despite the challenges that came with major COVID shutdowns and changing requirements, the healthcare system and patients have been both creative and
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Your Room is Ready: How to Recapture Health System Revenue by Solving “The Motel Problem”
Healthcare leaders attempting to regain some of the revenue lost during the COVID-19 shutdowns now face a formidable challenge. The American Hospital Association estimates that U.S. hospitals and health systems lost $202.6 billion in just the four months from March 1 through June 30—roughly $50.7 billion per month.
Many variables feed into the overall financial impact for individual healthcare organizations, of course—including geographic location, local ordinances, specialty designations,
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NLP is Raising the Bar on Accurate Detection of Adverse Drug Events
Each year, Adverse Drug Events (ADE) account for nearly 700,000 emergency department visits and 100,000 hospitalizations in the US alone. Nearly 5 percent of hospitalized patients experience an ADE, making them one of the most common types of inpatient errors. What’s more, many of these instances are hard to discover because they are never reported. In fact, the median under-reporting rate in one meta-analysis of 37 studies was 94 percent. This is especially problematic given the negative
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COVID-19: How Can Payers Prepare for Mandates and Support Pandemic Relief Efforts
Healthcare can achieve optimum efficiency when patients are at the center of care. When patients have the necessary information to navigate their care journey, they will choose the path to high-quality care at the lowest costs. Cost-sharing and insurance premiums are rising consistently since the last decade for employer plans, which covers nearly half of the country’s population. Plan members are shouldering a part of the healthcare cost burden, so they want to keep it as low as possible. At
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