-
If you're not paying as much attention to documentation and medical necessity for Medicaid patients as you do for those covered by Medicare, your hospital is likely to suffer when the Medicaid Recovery Audit Contractor (RAC) program starts on Jan. 1, 2012.
-
(Editor's note: This is a multi-part series where we will explore the most common roles, functions, models, and caseloads in the hospital case management field.)
-
Key components of the initiatives include forging an alliance with post-acute providers, transition coaching for at-risk patients during the hospital stay and after discharge, and teaching patients to use their personal health record to track their care and list questions for providers, according to Tammy Cole-Poklewski, RN, MS, director of quality, patient safety, and care management at the 142-bed facility.
-
After Charleston (WV) Area Medical Center began a readmission reduction program, readmission rates for a group of targeted heart failure patients was reduced by 50%.
-
In response to comments from healthcare professionals, the Centers for Medicare and Medicaid Services (CMS) made significant changes to the final rule for the creation of accountable care organizations (ACOs), which encourage providers to better coordinate care across all settings.
-
When it's typical for patients to wait four hours or more to see an emergency physician, and your leave-without-being-seen (LWBS) rate is pushing 10%, you know it's time to rethink the whole process.
-
One survey every three years is trying enough. But for Novant Health's Presbyterian Hospital in Charlotte, NC, that would have seemed like a vacation. Between June and August of this year, the hospital had a Joint Commission survey, a CMS survey, and the regular biannual visit from the local health department.
-
Grena Porto, a principal consultant with QRS Healthcare Consulting in Delaware, has made a career out of advocating for patient safety and improved quality. It should not have surprised some people, then, when she posted on a patient listserv all the reasons why she believes peer review doesn't work and detailed a number of cases to illustrate why.
-
Imagine the ongoing dismay of a high school math teacher who year in and year out has to teach students how to do the problems the right way, and year in and year out sees the same mistakes over and over again.
-
The final rule related to recovery audit contractors (RACs) for Medicaid was released in mid-September (http://www.gpo.gov/fdsys/pkg/FR-2011-09-16/pdf/2011-23695.pdf), just over three months before it goes into effect. It provides a variety of guidance and opt-outs for states that have many compliance experts scratching their heads.
