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To help members of its Medicare Advantage Plan stay healthy, healthcare professionals at WellPoint make individual outbound calls to members with clinical gaps in care to remind them of what preventive measures they need.
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In a concerted effort to improve patient care, payers and providers are collaborating to improve transitions of care and reduce readmissions.
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A new study, led by researchers at the University of Michigan (UM) in Ann Arbor, suggests that clinicians might not be spending enough time discussing some of the most complex patients when they are handing off these cases during shift changes.
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In an effort to drive down health care expenditures, a key target of state legislatures and healthcare policy makers in recent years has been frequent users of the ED. The thought is that many of these patients are using the ED for routine or non-urgent care when they really should be opting for less-expensive care settings.
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Safe patient handling should be standard practice, not best practice. That is the message behind new, draft standards issued by the American Nurses Association (ANA).
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Hospitals may eventually receive some relief from the burdens of the Centers for Medicare & Medicaid Services (CMS) Recovery Auditor (RA) program (previously called the Recovery Audit Contractor [RAC]) program but dont think the RAs are going away.
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Hospitals that appeal their denials by the recovery auditors (RAs) recoup their money 75% of the time, according to data provided by the American Hospital Association. But, only 40% of denials are appealed.
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The multidisciplinary team on each unit at Springfield Regional Medical Center in Springfield, OH, holds short team huddles at a specific time every day and reviews each patient, the plan of care and goals, and what needs to happen each day.
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After Springfield Regional Medical Center in Springfield, OH, began daily multidisciplinary team huddles to facilitate patient care, the hospitals performance on targeted core measures rose to the 95th quartile compared to a range of 75% to 81% when the project began, and the housewide ratio of the observed-to-expected length of stay decreased from 1.15 to 1.07.
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The American Hospital Association reports that 88% of all hospitals responding to its RACTrac Web-based survey have received an audit under the Recovery Auditor (RA) program.
