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When Bronson Methodist Hospital in Kalamazoo, MI, examined throughput in the emergency department, it determined that a culture change was needed to shorten wait time and make sure patients meet inpatient criteria and are admitted in the right status.
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In addition to losing reimbursement when cases dont meet medical necessity, hospitals face additional lost revenue if the credentials of all personnel who provide care for patients are not up to date and the staff are performing interventions for which they are not licensed.
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Days before Hurricane Sandy roared through the East Coast, the case management staff at Lutheran Medical Center in Brooklyn was working overtime to discharge patients and free up beds for patients injured in the storm or being evacuated from other hospitals and skilled nursing facilities.
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Medical City Dallas Hospital is taking a proactive approach to Medicares prepayment review process.
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A key to the success of Monmouth Medical Centers readmission program is ensuring that patients get the care they need after discharge and understand their treatment plan and medication regimen.
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Before Kootenai Medical Center in Coeur d'Alene, ID, began its pain care management program, emergency department physicians were spending 36% of their work day seeing patients whose primary complaint was pain, excluding orthopedic patients and those experiencing chest pain.
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Before North Broward Medical Center in Deerfield Beach, FL, re-engineered its discharge process two years ago, 29% of patients were being readmitted within 30 days. Now, the figure has dropped to 15%.
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The U.S. Department of Health and Human Services (HHS) has delayed the implementation of the ICD-10 procedure and diagnostic coding set, but that doesn't mean that hospitals can forget about preparing for the conversion to the new system, says Deborah Hale, CCS, CCDS, president and chief executive officer of Administrative Consultant Service, a healthcare consulting firm based in Shawnee, OK.
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Many hospital associates believe that registration staff simply sit at their desk and greet patients, reports Barbara Blum, director of access, admitting, and registration at MedStar Health in Columbia, MD. "They have no idea what the registration staff's responsibilities include," Blum says.
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The Centers for Medicare and Medicaid Services (CMS) instructed state Medicaid agencies to develop a RAC program by Jan. 1 of this year but the program is not expected to be in full swing until well into 2013.
