Centers for Medicare and Medicaid Services (CMS)
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Safety net hospital, community providers collaborate to improve transitions
A Care Transitional Task Force at San Francisco General Hospital created a cross-continuum program that has reduced readmissions and increased timely primary care visits for discharged patients.
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CMS gives the RA program a makeover with more changes in store
CMS has made changes in the scope of work for the Recovery Auditor program and has proposed a number of other changes to be implemented when new RA contracts are issued.
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Get status right up front for fewer headaches later on
As CMS’ audit program evolves, it’s crucial for hospitals to prevent denials on the front end.
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Financial stakes rising as auditors set their sights on providers
The Centers for Medicare & Medicaid Services is continuing to tweak its various audit programs, and the changes make it imperative that case managers stay current so they can educate the rest of the staff.
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Discharge Planning Requirements at a Glance
What hospitals should consider in evaluating a patient’s discharge needs.
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Preventing readmissions is a core focus of new discharge planning rules
In the proposed changes of the discharge planning portion of the Medicare Conditions of Participation, CMS reaffirms the goal of preventing hospital readmissions by ensuring safe transitions.
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New discharge planning rules focus on preferences, transitions
The Centers for Medicare & Medicaid Services has issued proposed changes to the Medicare Conditions of Participation that would increase the focus on patient preferences in the discharge process and beef up communication when patients are discharged from the hospital.
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The Challenge of Advance Care Planning Billing
Providers can now bill Medicare for advance care planning, eliminating one important barrier to end-of-life conversations.
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Experts: Population health needs to address mental health
White, middle-aged Americans have an increasing mortality rate due to behavioral and mental health issues, demonstrating the need for population health to address behavioral health.
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Here’s a snapshot of a model for case managers embedded with PCPs
Some healthcare organizations are finding that embedding case managers in primary care provider practices is an ideal way to help high-risk patients receive the care coordination and engagement they need to remain healthy.