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Centers for Medicare and Medicaid Services (CMS)

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  • Providers team up to cut HF readmissions

    A Hartford (CT) Physician Hospital Organization's program to reduce the rate of readmission for patients discharged with a primary diagnosis of heart failure has kept the readmission rate at between 11% and 13% for the last year, according to Linda Conroy, RN, BSN, clinical integration case manager for the Hartford Physician Hospital Organization, a partnership between Hartford Hospital and Hartford Physicians Association.
  • Ambulatory Care Quarterly: Rapid intake energizes no-wait ED model

    Getting an entire staff of physicians, nurses, and techs to do things differently is never easy, but you can clear away hurdles by giving them the ability to formulate some of their own solutions. That, at least, has been the experience of Swedish Medical Center in Issaquah, WA, in its quest to implement a more efficient, no-wait ED concept. The approach appears to be sitting well with patients, too.
  • Multi-faceted program cuts HF readmissions

    After Good Samaritan Hospital Medical Center in West Islip, NY, began a comprehensive process to reduce readmission rates for heart failure patients, readmission rates dropped from 21.1% to 15.3% in just a few months.
  • Treat challenging patients with understanding, respect

    Every case manager encounters challenging patients and family members those who are angry, provocative, depressed, or just plain ornery. That's because people in the hospital are sick, under stress, and often fearful about their situation.
  • Redesign standardizes care coordination

    A far-reaching redesign of the care coordination process at Norfolk, VA-based Sentara Healthcare has standardized the process across hospitals, centralized the administrative and clerical tasks that care coordinators must perform, and freed the staff at the bedside to concentrate on working with patients.
  • Don’t wait to revamp insurance verification

    Healthcare reform makes processes for insurance verification a top priority for patient access areas, says Sebrena Johnson, manager of insurance verification and precertification in the Admission Services Department at Cone Health System in Greensboro, NC.
  • Do you tell patients about charity care?

    Your patient access department already might have a discount policy in place, but this policy doesnt do anything to help a patient unless he or she is aware of it.
  • You must get ready now for many more eligibles

    Patient access departments need to prepare for a great increase in the volume of patients who are eligible not only for Medicaid, but also private insurance policies, as a result of the Patient Protection and Affordable Care Act (PPACA) according to Luis Guerrero, director of patient access services at Ochsner Baptist Medical Center in New Orleans.
  • Self-pay A/R cut by $15 million

    Self-pay accounts receivable (A/R) was reduced by about $15 million annually after the patient access department at Geisinger Health System in Danville, PA, implemented daily eligibility checking of self-pay accounts against Medicare and Medicaid to find instances in which patients had coverage for that particular date of service.
  • Patient may not be ‘true’ self-pay

    Patient access staff at Methodist Charlton Medical Center in Dallas now run all self-pay patients through an automated verification system to identify those that are unaware that they are still active with the Medicaid program.