Thanks to all the great subject matter experts and their contributions to RCM Answers this year. Here’s the ten you read and shared the most.
MU, PQRS and VBM Create New Payment Model MIPS
By Peggy Losey, Manager of Ambulatory Incentive Programs, ehealthcare Consulting Inc.
Twitter: @ehealthcareorg
MIPS. The emerging Medicare payment model where MU, PQRS and VBM intersect, and the construction of the payment system focusing on providing value and quality, begins. How are you doing with Meaningful Use, PQRS and VBM? Are you using your QRUR as a roadmap to help get you there? Accepting a little road trip advice now will help you prepare for a safe arrival at your destination with minimal detours. CMS recently announced that the implementation of this program has begun. Are you on the right road? Continue reading on RCMAnswers.net…
Patient Data, Population Health, a Predictive Model and Reducing Readmissions
By Sarianne Gruber
Twitter: @subtleimpact
Worthy of recognition is the paper “Predicting Readmission Risk with Institution Specific Prediction Models” authored by Shipeng Yu, Alexander van Esbroeck, Faisal Farooq, Glenn Fung, Vikram Anand and Balaji Krishnapuram, a collaborative team from Siemens Healthcare and University of Michigan. This readmission model study is illustrative as to why healthcare analytics has a vital role in meeting challenges of new policies, managing population health, pinpointing gaps in existing modeling methods and in predicting a patient’s risk to readmit. This review provides a historical, analytical perspective on a new institution-specific prediction model. Continue reading on RCMAnswers.net…
Ignoring HIPAA Law Costly for Hospital
By Mike Semel
Twitter: @SemelConsulting
Once you become aware of a HIPAA data breach it is not a good idea to sweep it under the rug, especially when that is breaking the law and anyone who finds out can report you. Just because they are free and easy doesn’t mean you should use just any Internet file sharing service for storing patient information. Nor should you let former employees store patient data on personally-owned laptops and flash drives. These lessons can all be learned from the most recent HIPAA penalty reported by the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR). Continue reading on RCMAnswers.net…
Top 10 Considerations When Transitioning Physicians to Payment-for-Value
By Tawnya Bosko, MHA, MSHL, MS, Senior Manager, The Camden Group
Twitter: @TheCamdenGroup
With increased focus on payment based on value, physician practices and those involved with physician practices need to plan for how to transition to new reimbursement models. Here are the top considerations to keep in mind when implementing value-based structures: Continue reading on RCMAnswers.net…
Predictive Modeling Can Detect Meaningful Correlations across Claims Denials Data
By Paul Bradley, Chief Data Scientist, ZirMed
Twitter: @Zirmed
The reasons claims are denied are so varied that managing denials can feel like chasing a thousand different tails. This situation is not surprising given that a hypothetical denial rate of just 5 percent translates to tens of thousands of denied claims per year for large hospitals—where real-world denial rates often range from 12 to 22 percent. Continue reading on RCMAnswers.net…
Consumer Expectations and the Future of Patient Engagement
By Ric Sinclair, VP of Product, ZirMed
Twitter: @Zirmed
Can you imagine what the “Terms and Conditions” would look like for a site where you agreed to a purchase up to and even beyond the limit of your credit card—with no idea what the purchase amount would ultimately be? And more to the point, can you imagine anyone agreeing to them? Of course not. Continue reading on RCMAnswers.net…
Population Health Management Best Practices for Today and Tomorrow’s Healthcare System
By Justin Barnes
Twitter: @HITAdvisor
The transition to value-based care is not an easy one. Organizations will face numerous challenges on their journey towards population health management. We believe there are five key elements and best practices to consider when transitioning from volume to value-based care: managing multiple quality programs; supporting both employed and affiliated physicians and effectively managing your network and referrals; managing organizational risk and utilization patterns; implementing care management programs; and ensuring success with value-based reimbursement. Continue reading on RCMAnswers.net…
Concierge Medicine: A Thought Provoking Form of Practice
By Matt Fisher, Esq
Twitter: @matt_r_fisher
Concierge medicine is a term and concept often discussed, but at the same time often not fully understood. It is not necessarily a new model of practice, but it has gained significantly increased attention since passage of the Affordable Care Act. From one perspective, concierge medicine creates small, boutique medical practices that charge a fee for access, which is represented as limiting the types of patients that can remain in or access the practice. From another perspective, concierge practice enables a physician to spend more time with each patient while offering more personalized services for what could be a modest fee. Each perspective contains a kernel of truth. Continue reading on RCMAnswers.net…
How to Meet Diverse Digital Demands in Healthcare
By Jonathan Catley, Online Sales & Marketing Manager, MD Connect
Twitter: @JonathanCatley
Unlike a majority of marketers who promote a single product, healthcare marketers don’t often have the luxury of honing in on one specific target market. Medical care is a necessity for patients young and old, male and female, short and tall. Illnesses and diseases won’t discriminate, and with your digital marketing materials, you have to engage them all. Continue reading on RCMAnswers.net…
Meaningful Use Audit Outcomes: Data Released by CMS
By Steve Spearman, Founder and Chief Security Consultant, Health Security Solutions
Twitter: @HIPAASolutions
For eligible providers (EP) and hospitals (EH), attesting to Meaningful Use can have a huge financial impact on their organization. When an organization attests, they are required to satisfy a certain number of objectives and associated measures demonstrating the meaningful use of certified electronic health record technology (EHR). If the Meaningful Use (MU) standards are met, organizations receive significant incentive payments that help remediate the cost of implementing use of an EHR. Continue reading on RCMAnswers.net…