Health Care Reform Archives - Page 10 of 31 - BHM Healthcare Solutions

The Penalty Box | CMS’ 3 Ways to Ding Hospitals

2017-04-02T13:28:35-04:00By BHM Marketing|Compliance, Financial, Financial Analysis, Health Care Reform, Medicare and Medicaid, Quality Improvement Programs, Readmissions, Services|

Are you one of many hospitals being dinged with CMS penalties? Are you ready to be dinged for Hospital Acquired Conditions, in addition to readmissions and value-based purchasing? How can a hospital remain profitable? In terms of hockey, the penalty box is where players are sent when they have committed an act which is against the regulations of the game. The player is forced to sit in the penalty box for a period of time, causing the team to play with less players, until the penalty time has lapsed.

The Top 5 Mistakes Hospitals With High Readmission Rates Are Making

2017-04-02T13:28:35-04:00By BHM Marketing|Care Coordination, Health Care Reform, Readmissions|

While there are plenty of complex reasons for high rates of readmission, there are plenty that are preventable. Here are the Top 5 Mistakes made by hospitals who top this list.

6 Healthcare IT Pain Points | What Are Your Pain Points?

2017-04-02T13:28:37-04:00By BHM Marketing|Big Data, Clinical Analysis, Financial Analysis, Health Care Reform, Operational Analysis, Services, Telehealth and Telemedicine|

Healthcare technology is changing faster than most organizations can keep up. What are you doing to comply? Healthcare technology is a rapidly changing field. Some of the changes are required to comply with current regulations while others are to gain a competitive advantage. Lets’ delve into a few of these areas.

Play or Pay | The Triple Aim for 2015 and Beyond

2017-04-02T13:28:37-04:00By BHM Marketing|Health Care Reform, Health Insurance, Health Insurance Exchange|

What will you decide for your organization beginning 2015? Will you “play or pay”? The “play or “pay” principle basically says that if employers with 50 or more full time employees don’t meet the minimum requirements of offering insurance coverage, they will pay very steep penalties. The provision will be phased in beginning in 2015. The “play or pay” principle is part of the PPACA, specifically under the provision of “shared responsibility”.

Are ACOs The New HMOs?

2023-07-28T14:56:33-04:00By BHM Marketing|Accountable Care Organizations, Financial, Health Care Reform|

Historically, HMOs are notorious for incurring poor health among patients and bolstering already bloated administrative costs. When healthcare reform was on the horizon, the promise of Accountable Care Organizations in lieu of traditional HMOs lifted the wilted spirits of doctors and patients alike. A few years of ACOs, however, seems to have done little to assuage the initial fears of these groups that ACOs are just nicely dressed HMOs.

Defining Healthcare Value

2017-04-02T13:28:37-04:00By BHM Marketing|Accountable Care Organizations, Health Care Reform, Physician Compensation, Quality Improvement Programs|

One of the greatest challenges in healthcare currently is not so much a matter of practice, but definition. How has ‘value’ been defined and do we need to alter our definition to reflect the ongoing evolution of our healthcare system?

Can Google Make Us Live Forever? What is ‘Google Calico’ and What Does It Have To Do With Modern Healthcare?

2017-04-02T13:28:37-04:00By BHM Marketing|Big Data, Health Care Reform, Healthcare Preventitive Care|

You may recall some murmurings last year about a new Google venture cryptically called Calico. In the heyday of 23andMe, Apple’s many health apps and the hefty focus on technology in healthcare, Google wasn’t about to miss out on the hoopla. But just as soon as we started hearing chirps about “Google’s war on aging”, it sunk into the deep obscurity of the web.

7 Ways to Improve Your Readmission Rates

2017-04-02T13:28:37-04:00By BHM Marketing|Care Coordination, Clinical Analysis, Health Care Reform, Readmissions, Services|

As most of us are aware, readmissions is a hot topic, especially in terms of the penalties assessed for readmission rates which are excessive. What can you do to reduce or eliminate your readmission rates? There has been a lot of talk about readmissions (avoidable), specifically the healthcare costs associated with them and the effects on the quality of patient care being provided. In order to crack down on these avoidable readmissions, CMS created the Readmissions Reduction Program. The premise of the program is to ding hospitals, with higher than average readmissions (readmitted within 30 days of discharge), by assessing penalties against overall Medicare payments. There has been a lot of hoopla surrounding the program, with many criticisms being cited, such as treating all hospitals alike, not accounting for socioeconomic factors, and the way the penalty is calculated.

Are You Ready for 2015 Readmission Penalties?

2017-04-02T13:28:37-04:00By BHM Marketing|Clinical Analysis, Health Care Reform, Health Insurance, Medicare and Medicaid, Readmissions, Services|

What are you doing to make sure you are not one of the 66% of hospitals who will be assessed readmission penalties in the next round? Can you afford the penalties which are increasing again in 2015? Are you aware of the proposed conditions to be added in 2015? What do you get when you combine Medicare, high readmissions, within a 30 day window, for specific conditions? A reduction in Medicare spending to the tune of about $280 million annually. Of interest is that penalties were assessed in 49 states, all with the exception of Maryland, who has a unique reimbursement payment system.

9 Criticisms to the Readmission Reduction Program

2017-04-02T13:28:37-04:00By BHM Marketing|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.

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