Yesterday the House of Representatives voted on a bill that included a proposal for delaying the implementation of ICD-10 for another year, bringing the compliance date to October 2015. Hospitals nationwide are in the throes of gearing up for the implementation deadline in October of this year, a mere six months away. While some who are not in healthcare may view the delay as a sign of relief, those who have been spending time and money on the implementations are not sighing so much as groaning at the possibility of pushing the deadline out further.
What is the 2 Midnight Rule? What does it mean for your organization? How does it affect the amount Medicare patient’s pay out of pocket? How does the 2 Midnight Rule affect reimbursement from both inpatient and outpatient perspectives? The 2 Midnight Rule establishes guidelines as to whether or not a physician should admit a patient from outpatient to inpatient. The general rule is if the patient, based upon medical necessity, is expected to require care that will span at least 2 midnights, the patient should be admitted as inpatient, and therefore reimbursable under Medicare Part A. In determining the 2 midnights, all care including outpatient is used in the determination. However, in terms of reimbursement, outpatient is reimbursed via Medicare Part B provisions and inpatient is reimbursed via Medicare Part A provisions.
A patient-centered focus will provide optimal care for the patient which will in turn drive revenue. Do you remember the movie “Field of Dreams”? The basic premise was if you build a stadium they will come. We can adapt this adage to healthcare as well. So many organizations become so focused on the bottom line and don’t realize that if patients aren’t satisfied, they will not return to your facility, they will relay their bad experience to all of their friends, and you will lose revenue.
Under the terms of the Patient Protection and Affordable Care Act (ACA), Medicaid payment rates were to be increased to (at least) match Medicare reimbursement rates for primary care and immunization services provided in 2013 and 2014.
Obamacare mandates that you have insurance or pay a penalty. Now, physicians are refusing to take patients who have insurance? Is this counterintuitive? How will this affect the “affordable” and “accessible” care which Obamacare strives to achieve?
As we know by now, the expansion of Medicaid was one of the major points of contention within the Affordable […]
How is Medicaid Expansion impacting healthcare in general, healthcare exchanges/subsidies in particular?In keeping up with the holiday traditions, we are highlighting the 12 days of Obamacare. As such, on the 7th day of Obamacare, Obama gave to me: Medicaid Expansion, Increased Age for Children, Affordable Healthcare, No Pre-existing, Preventive care, Healthcare Exchanges, and an Individual Mandate
Summary: Keeping with the theme of the season, we thought it only fitting to create an article on the 12 days off Obamacare. The Affordable Care Act a.k.a Obamacare was enacted in 2010 with provisions becoming effective through 2015 and beyond. The goals of this legislation are to provide care which is affordable, accessible, accountable, coordinated, and of high quality while reducing healthcare spending. Following are the 12 days of Obamacare:
How does an organization comply with all of the ACA requirements in terms of quality? What initiatives exist? How is the shift from quantity to quality accomplished? What are the implications in terms of delivery systems, accreditation, reporting, and accuracy?
Medicare Versus Medicaid - what are the similarities and differences? Both programs are government-sponsored through federal, state, or a combination thereof. Medicaid is a joint federal and state program that helps with medical costs for some people with limited income and resources. Medicaid programs vary from state to state, but most health care costs are covered if you qualify for both Medicare and Medicaid.