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Research professionals increasingly are aware of how important it is to assess and anticipate research volunteers' comprehension before writing informed consent documents. Still, the industry is lagging behind the reality, an expert says.
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Aurora Health Care of Milwaukee, WI, has had a very good track record in research billing compliance in recent years, and its success can be attributed to its billing compliance best practice model.
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Compliance officials can call principal investigators (PIs) and let them know about a scheduled audit, but chances are the site will be inadequately prepared for an efficient audit visit.
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Often the best research compliance programs are not the result of overnight inspiration, but are developed through a long, experience-building process.
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Integrating care for dual-eligibles clearly presents many opportunities for state Medicaid programs. Unfortunately, progress has been slow, according to The Commonwealth Fund's November 2009 policy brief "Supporting Alternative Integrated Models for Dual Eligibles: A Legal Analysis of Current and Future Options."
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Just 10% of enrollees, two-thirds of whom have a chronic condition, account for 72% of spending on children in Medicaid and the Children's Health Insurance Program(CHIP), according to a study published by Genevieve M. Kenney, PhD, Thomas Selden, and Joel Ruhter in Health Affairs, "Containing Costs And Improving Care For Children In Medicaid And CHIP."
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Lean management techniques helped Lahey Clinic Medical Center, North Shore, in the city of Peabody, MA, boost patient satisfaction and reduce emergency department (ED) waiting times.
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In Oklahoma, a health management program targets high-cost and/or high-utilization Medicaid clients, both adults and children. "Through predictive modeling, we identify our members, adults and children, at risk for higher costs or utilization. If they are within the targeted top 5,000 at highest risk and agree to participate, we enroll them in our health management program," says Marlene Asmussen, RN, director of SoonerCare Medicaid care management and health management.
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Medicaid providers may be eagerly awaiting incentives to purchase electronic health records (EHRs) for their practice, as a result of funding from the HITECH Act. However, at this juncture, some troubling questions remain.