Centers for Medicare and Medicaid Services (CMS)
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They're Back! CMS Audits Are Ratcheting Up
Hospitals have had a reprieve from record requests, denials, and appeals, but that’s about to change as CMS ramps up its auditing programs.
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For Better Patient Care, Communicate Early and Often
In today’s healthcare world, communicating with other clinicians in the hospital and in post-acute provider organizations is essential to ensure patients receive the care they need to stay out of the hospital and the ED.
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No Crystal Ball Needed to Know Where CMS May Focus
To get a good idea of what diagnoses CMS will add to the readmission reduction program or other value-based purchasing programs, look no further than the Hospital Inpatient Quality Reporting Program components.
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Under New Leadership, CMS Continues Emphasis on Quality
Despite all of the changes in Washington, DC, the Centers for Medicare & Medicaid Services remains committed to providing high-quality, efficient, and cost-effective care.
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Study: Readmissions More Common After Observation Stays
Patients often are readmitted to the hospital after an observation stay, according to recent research which suggests hospitals may want to target this population.
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Expert: Health Systems Should Emphasize Value-based Care Management
Since health insurers first developed case management programs in the 1980s, the marketplace for case management has evolved and changed across the continuum of care, with one possible exception: hospital settings.
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Recent CMS Payment Model Cancellations Could Affect Case Management
Case management programs could see some effects from the recent canceling of advanced care coordination through episode payment by the Centers for Medicare & Medicaid Services.
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Case Management Program Cuts Heart Failure Readmissions in Half
A case management program targeted health improvements among congestive heart failure patients and succeeded in cutting readmission rates to half the national average.
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What’s Old Is New Again: The History of Case Management
This month, we will review case management’s long and rich history from a community-based model to an acute care model and beyond.
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High-needs Patients Require Focus to Avoid Readmissions
Hospitals can make significant headway in reducing readmissions by addressing high-needs patients, according to a new National Academy of Medicine special publication, which notes that nearly half of the nation’s spending on healthcare is driven by just 5% of patients.