By Matt Fisher – With healthcare gradually (or rapidly) moving from a fee for service (FFS) world to a value-based care world, questions about the laws and regulations governing relationships within healthcare are increasing. The predominant current regulatory framework, exemplified by the Stark Law and Anti-Kickback Statutes.
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Health care in many U.S. communities got better between 2011 and 2014, although persistent wide variation indicates there is room for improvement across the country, according to a Commonwealth Fund report.
By Mordy Pelleg – For clinicians working in the complex American healthcare system, getting paid for every single procedure, service and visit has always been something of a challenge. Yes, fee-for-service medicine created a fairly linear relationship between effort and remuneration, but even in that scenario many hospitals and practices have teetered on the edge of solvency, in part for lack of efficient billing practices.
By John Halamka MD – Would you buy an iPhone if the only apps that ran on it were written by Apple? Maybe, but the functionality would not be very diverse. The same can be said of EHRs. Athena, Cerner, Epic, Meditech, and self developed EHRs such as BIDMC’s webOMR are purpose-built transaction engines for capturing data.
By Glenn Krauss – Clinical documentation improvement specialists play a vital role in the hospital revenue cycle world. When one refers to “CDI,” what in-arguably comes to mind is clarification of diagnosis, whether it be primary or secondary diagnosis, HACs or present on admission indicators.
The Centers for Medicare & Medicaid Services finalized new rules that will enrich the Qualified Entity Program by expanding access to analyses and data that will help providers, employers, and others make more informed decisions about care delivery and quality improvement.
By Andy Slavitt & Patrick Conway – We have historically invested far more in treating sickness than we do in maintaining health. The result of this imbalance is not only poorer health, but more money spent in institutions, hospitals, and nursing homes. The road to a better health care system means correcting this imbalance.
Carequality, a nationwide framework for trusted exchange across different health data sharing networks, is now accepting applications for its Steering Committee. The committee seeks to build a broad representation of the healthcare ecosystem to continue to develop real-world, scalable interoperability solutions. Everyone is welcome to apply by July 29, 2016.
On July 7, CMS proposed changes to the Physician Fee Schedule to transform how Medicare pays for primary care through a new focus on care management and behavioral health designed to recognize the importance of the primary care work physicians perform. The rule also proposes policies to expand the Diabetes Prevention Program within Medicare starting January 1, 2018.