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In November 2012, a multi-hospital healthcare system settled allegations of improperly compensating physicians from its many clinics for referrals of Medicare and Medicaid patients. It was alleged by the United States Department of Justice Civil Division that these actions were in direct violation of the False Claims Act and Stark Law. The hospital system agreed to pay $9.3 million to settle those allegations.
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Want a healthier, happier workforce? Try the team approach to wellness.
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Of the hundreds, if not thousands, of patient safety strategies employed at hospitals across the country, the Agency for Healthcare Research and Quality (AHRQ) has released a report identifying the top 10 patient safety strategies that can be implemented immediately by healthcare providers.
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When doctors, nurses, and other hospital operating room staff follow a written safety checklist to respond when a patient experiences cardiac arrest, severe allergic reaction, bleeding followed by an irregular heartbeat, or other crisis during surgery, they are nearly 75% less likely to miss a critical clinical step, according to a new study funded by the Agency for Healthcare Research and Quality (AHRQ).
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A proactive approach to the Recovery Auditor (RA) process has paid off for Alamance Regional Medical Center in Burlington, NC. Out of more than 800 denials from the auditor, the hospital has appealed up to the administrative law judge level, if necessary. So far, the hospital has won a high percentage of the appeals. Many are still pending because of a backlog.
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Gundersen Healths integrated care coordination program, in which a team of RN care coordinators and social workers follows the 1% to 2% most complex patients through the continuum, has resulted in a 46% decrease in average length of stay and a 64% decrease in unplanned hospital admissions or emergency department visits.
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As the Centers for Medicare & Medicaid Services (CMS) Value-Based Purchasing program moves toward basing reimbursement on quality, case managers can take the lead in making sure their hospitals score well and dont lose reimbursement.
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In the last two issues of Case Management Insider, we discussed issues associated with identifying and monitoring patient flow. This month we continue our discussion with a focus on the elements of patient flow associated with the inpatient setting. These issues relate directly to the provision of care as well as the progression of care for patients as they move through the acute-care continuum.
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When Patewood Memorial Hospital in Greenville, SC, opened six years ago, the hospital administration recognized an opportunity to provide care that was centered around the patients and family members experiences, or patient-centered care, says Beverly Haines, MNEd, BRN, NE-BC, president of the 72-bed surgical hospital, which is part of the Greenville Health System.
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The American Medical Association's Physician Consortium for Performance Improvement and The Joint Commission have come up with ways to reduce five commonly overused treatments use of antibiotics for viral infections like colds, over-transfusion of red blood cells, placing tubes in ears for middle ear infusion, early elective delivery, and elective percutaneous coronary intervention (PCI).
