How to Train Your Dragon: Patient Documentation in the 21st Century

What's one thing you never see Grey’s Anatomy? A doctor sitting down at 3 am to dictate on a patient. Or write a note in their chart. I don’t even remember seeing a doctor on that show even look at a patient’s chart, let alone glean any valuable information from it. No one becomes a doctor because they love to document.

5 Aspects of CMS’ 2015 Proposed IPPS Regulations

On April 30, 2014, CMS announced proposed IPPS regulations to become effective January 1, 2015. The ruling covers: Hospital Value-Based Purchasing Program, Hospital Readmissions Reduction Program, Hospital-Acquired Condition Reduction Program, Quality Reporting Programs, and Wage Index – Updated Labor Market Areas. CMS just announced proposed regulations to become effective January 1, 2015. These regulations further the goals of the Affordable Care Act: increasing patient outcomes and reducing healthcare spending. These proposed regulations are Medicare specific and, if approved, will be applicable to general acute care and long-term care hospitals.

RAC Audits Still Haunting Medicare Patients, Hospitals.

Since last fall, the Recovery Audit Contractors have greatly slowed their requests for charts from hospitals nationwide. The program, which has been under fire from the American Hospital Association virtually since it’s inception in 2006, is currently undergoing reform. That being said, for many involved in the previous audits the damage has already been done.

Do Patient Satisfaction Surveys Help or Hurt Reimbursement?

The “patient is always right” model has been the primary driving force behind healthcare for the last several decades. But is this the right approach? Classifying patients as “customers” is a slippery slope. While you might be able to barter with a customer at a shop about the price of a necklace, should doctors ever barter with a patient about their treatment? What about when their patient satisfaction scores are drooping low?

ICD-10 Delay: Does ICD-10 Lack Clinical Value?

ICD-10 was delayed once again as part of a bill that was meant to fix the physician reimbursement issues with Medicare. The ICD-1o delay was merely a footnote in a jam-packed bill that was going to make many doctors very happy; incidentally, pushing out the date for ICD-10 implementation also pleases many physicians. Some have gone so far as to say, on record, that ICD-10 lacks clinical value.

Medicare Advantage Cuts Not Only Delayed But Reversed

Summary: CMS has reversed its original proposal to cutback Medicare Advantage plan reimbursement for 2015. The reversal is a result of aggressive lobbying from organizations such as the American Medical Association. What is Medicare Advantage? According to www.medicare.gov, a Medicare Advantage plan is “a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you're enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren't paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.”

Dual-Eligibility: An overworked & overlooked population?

9 million Americans are covered by both Medicare and Medicaid and are part of a unique community of healthcare consumers known as the dual eligible. Dual eligible beneficiaries often have complex health conditions and may be low income, meaning that their access to healthcare would be greatly limited if not for their dual eligibility for coverage.

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