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9 Criticisms to the Readmission Reduction Program

2017-04-02T13:28:37-04:00By |Clinical Analysis, Compliance, Financial Analysis, Health Care Reform, Health Insurance, Medicare and Medicaid, Quality Improvement Programs, Readmissions, Services|

The Readmission Reduction Program is designed to reduce healthcare spending while improving quality. There are both proponents and opponents of the program. Let’s delve into the improvements that could be made to the current system. So, as most of you are aware, CMS under the direction of HHS created the Hospital Readmission Reduction Program in order to reduce healthcare spending while improving the quality of care. The program is being phased in beginning with a 3 year baseline period in which hospitals were required to report all readmissions (within 30 days). CMS assessed and analyzed all of the available readmission data to determine how penalties should be assessed, for which conditions, and excluding certain circumstances. Beginning in October 2012, penalties were assessed to over 2,200 hospitals, equating to about $280 million. The phase in included an increase in penalties from 2013 to 2015 from 1% to 3%, where it is currently capped. Initially, there were 3 conditions included: Acute Myocardial Infarction, Heart Failure, and Pneumonia. For 2015, CMS is proposing 2 additional conditions: Chronic Obstructive Pulmonary Disease and Elective Hip and Knee Replacements.

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

2017-04-02T13:28:37-04:00By |Medicare and Medicaid, Physician Compensation, Services|

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.

Reducing Overcrowding in Emergency Rooms

2017-04-02T13:28:38-04:00By |Care Coordination, Clinical Analysis, Services|

Overcrowding in Emergency Rooms (ERs) has been an issue of great concern as of recent years. There are a myriad of reasons why the ERs are overcrowded and ways to overcome. Let’s have a look at them. Expand Hospital Capacity By increasing the bed capacity, overcrowding can drastically go down. When there are more beds, more emergency patients can be admitted. When the population of a country grows, then obviously the number of bed capacity should be increased to avoid overcrowding. Many times, hospitals are perpetually full with admitted patients boarded inReducing overcrowding the ERs. Boarding of inpatients in the ERs is unquestionably the leading cause of overcrowding. While this seems like a simple option, there are infrastructure, costs, and the redesign of processes, to name a few, which need to occur in order to successfully add bed capacity.

BHM Wishes You a Happy and Safe Memorial Day

2017-04-02T13:28:38-04:00By |Uncategorized|

BHM would like to recognize and thank all those who have lost their lives while defending our country. Our country would not be what it is today without the heroic efforts of our military. We commend and appreciate all of our current soldiers putting their lives on the line every day to make sure we are all safe. Memorial Day has different meanings for different individuals, some celebrate with parades and barbecues, while others mourn. Following is an interesting portrayal of the history of Memorial Day along with great facts, figures, and traditions.

ACA Acronyms | FFOF | Everything Has an Abbrev.

2017-04-02T13:28:38-04:00By |Accountable Care Organizations, Health Care Reform, Health Insurance, Health Insurance Exchange, Physician Compensation, Services|

What do the ACA, ACO, FFS, DHS, and QHP all have in common? They are healthcare acronyms and most are related to the Affordable Care Act. The healthcare industry is not unlike any other industry or almost any aspect of our lives these days, especially with the advent of texting. There is always a shorter way to say something i.e. “BFF” – best friends forever or one of my favorites “*$” - Starbucks. By the way, the title “FFOF” is Fun Facts on Friday. The ACA, which is part of the “PPACA” - Patient Protection and Affordable Care Act of 2010, is regulated by “HHS” - the division of Health and Human Services, the “DOL” – Department of Labor and the “IRS” – Internal Revenue Service. HHS designates many responsibilities to “CMS” – the Centers for Medicare and Medicaid Services.

Concierge Medicine | Paying for Convenience and Access

2017-04-02T13:28:38-04:00By |Health Care Reform, Physician Compensation|

What are the latest trends with concierge medicine? What are the pros and cons associated from both a patient and physician perspective? How does the ACA play into concierge medicine? How are healthcare trends affecting the future of healthcare? Is concierge medicine the answer? It is no secret that the physician shortage is growing in leaps and bounds, especially in terms of primary care. The creation of the Affordable Care Act has amplified the issue, adding more insured to the mix. The supply and demand ratio is completely unbalanced. As a result, both physicians and patients are looking for alternatives.

4 Level of Care Tools | Comparing Level of Care Assessment

2017-06-26T16:14:20-04:00By |Clinical Analysis, Services|

What do ASAM®, LOCUS®, CALOCUS®, and InterQual® all have in common? They are all level of care assessment tools, each with a different perspective. Level of care isn’t a new concept, but has gained in popularity in recent years. A level of care is used to indicate a level of intensity or severity and determine in what type of facility specific care should be performed. It is used to make sure the patient receives the right care in the right facility at the right time.

The Benefits of CARF Accreditation |The Value in CARF Accreditation

2017-04-02T13:28:38-04:00By |Accreditation, Services|

The Commission on Accreditation of Rehabilitation Facilities (CARF) was established in 1966 as an alternative to Joint Commission certification. Services provided by rehabilitation facilities are subtly specified in different ways than general hospitals. It’s fitting, then, that they have their own, more specified accreditation system for their services.

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