As 2015 approaches, many C-suite executives are bracing themselves for changes in the coming year. And as healthcare continues to rapidly evolve, addressing these five major concerns will help healthcare systems large and small anticipate any curveballs that come their way.
When we talk about outsourcing, the first defense that’s likely to surface is, “won’t that cost more money?” Hospitals frequently make the mistake of assuming that by conducting claim reviews in house they are automatically saving money. This illusion is understandable, since it’s long been the belief in many industries that the more you can do for yourself, the less money you have to spend hiring someone else to do it.
BHM would like to wish all of you a Happy and Safe New Year! Make 2015 the best year ever!
Technology has streamlined and improved products and businesses alike, without equally increasing the cost for improvements. This is called Moore’s Law: the idea that technological innovation doubles every two years. Administrative duties can be accomplished much more quickly and inexpensively with software programs and business apps. Cars can operate more safely with rear video and voice-activated unlock systems, without paying triple the price for these new features.
A November 2014 audit from the Office of the Inspector General (OIG) showed that as many states move from Medicaid to Managed Care Organizations (MCOs), access to a primary care physician involves some serious wait time. Because of these wait times, more and more Medicaid patients are filtering into healthcare systems through their emergency rooms, which impacts the continuum of care in a negative way.
If you need a quick refresher, Value-Based Purchasing is the incentive program that came along with the Affordable Care Act, which is hoping to help providers adjust to the move from fee-for-service models of pay to pay that is linked to quality rather than quantity of services. Under the VBP model providers and the organizations that they work for will be either docked Medicare payments for poor outcomes or awarded bonuses for striking a balance between high quality care and low cost. The hope is that VBP will inspire providers to become not just thriftier, but more innovative when it comes to providing care.
Back in 2013, Medicare proposed changes to its practices in reimbursement for telemedicine by adding seven new codes for this type of remote healthcare. These changes have been slowly making progress and put into action by practices and healthcare systems who are looking to increase their number of patient visits with the aid of technology and telehealth.
Happy Holidays from all of us at BHM Healthcare Solutions!
We appreciate your support during 2014 and hope your Holiday season is happy, healthy, and safe.
Think of clinical pathways as maps: imagine a patient coming into the emergency room with abdominal pain. That’s a pretty non-specific complaint, and it could easily send an ER docs mind spinning with possibilities. With this common complaint the patient’s condition could run the gamut from a mild case of indigestion to a potentially fatal acute abdomen: and it’s up to the doctor to suss out what’s causing the patient’s pain before their condition worsens.
2014 was another year big year for healthcare. As we continue to move toward a more patient-centered and transparent healthcare system, so too continue the changes to our payment models, insurance coverage and commitment to patient outcome measures. While there were many changes to keep track of, three things seem to have defined the progress made in the scope of revenue cycle improvement.
