Health Care Reform Archives - Page 11 of 31 - BHM Healthcare Solutions

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.

The Triple Aim, Explained.

2017-04-02T13:28:38-04:00By BHM Marketing|Financial Analysis, Health Care Reform, Quality Improvement Programs|

With hospitals moving toward a value-based payment system there is more demand now than ever for strategies that will help healthcare systems hone in on population health. The Triple Aim, an initiative set forth by the Institute for Healthcare Improvement, covers three main checkpoints for all hospitals as they make this transition.

ACA Acronyms | FFOF | Everything Has an Abbrev.

2017-04-02T13:28:38-04:00By BHM Marketing|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 BHM Marketing|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.

Obamacare & Murphy’s Law | Did It All Go Wrong?

2024-06-27T11:54:49-04:00By BHM Marketing|Health Care Reform, Health Insurance, Health Insurance Exchange|

Pundits began outlining the downfall of Obamacare as soon as the President was elected in 2008. Now that many programs have come to fruition, many folks who originally voiced concerns are tallying up the negative outcomes.

Show Me the Money | Profitability Through Value-Based Purchasing

2023-06-29T12:06:18-04:00By BHM Marketing|Accountable Care Organizations, Care Coordination, Financial Analysis, Health Care Reform, Health Insurance, Physician Compensation, Services|

Summary: Are you ready for a shift in risk from payer to provider? Will you be ready for value-based purchasing when it becomes required? Are you utilizing other reimbursement models such as bundled payments, Accountable Care Organizations, and Population Health Management? From a provider perspective, healthcare reform is aimed at tightening the purse strings, working more efficiently, reducing waste, and improving quality. The shift of risk has begun which will transform healthcare from a fee-for-service to fee-for-value. When the ultimate transformation ends, is still uncertain. As such, fee-for-service is still being utilized and providers are still generating profits and revenue based on the volume mentality while simultaneously trying to transition to a volume and quantity mentality. Juggling the opposite ends of the spectrum is no easy task.

5 Aspects of CMS’ 2015 Proposed IPPS Regulations

2017-04-02T13:28:39-04:00By BHM Marketing|Clinical Analysis, Compliance, Financial Analysis, Health Care Reform, Medicare and Medicaid, Physician Compensation, Readmissions, Services|

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.

New ACA Provision Calls For Cost Transparency in Hospitals

2017-04-02T13:28:39-04:00By BHM Marketing|Financial Analysis, Health Care Reform, Medicare and Medicaid|

New rules put forth by the ACA will require hospitals to be transparent about the costs of care at their facility. They can do this in one of two ways: either by releasing a list of procedures and their costs, or, releasing the information after an inquiry by a patient.

ACOs Rapidly Expanding Across States

2017-04-02T13:28:39-04:00By BHM Marketing|Accountable Care Organizations, Health Care Reform, News and Events, Services|

Accountable Care Organizations (ACOs) are gaining in popularity as a result of the ACA. BHM Healthcare Solutions, a healthcare management consulting firm, has a team of experts dedicated to providing assistance to organizations as they transition from a traditional fee-for-service model to an ACOs assisting in the critical transition to provide quality of care..

Benefits of ACOs to Both Patients and Providers

2024-06-26T10:44:51-04:00By BHM Marketing|Care Coordination, Financial Analysis, Health Care Reform, Health Insurance, PCHCH Accreditation, Physician Compensation, Quality Improvement Programs, Services|

Summary: Accountable Care Organizations (ACOs) are gaining in popularity as a result of the Affordable Care Act. Have you considered the benefits of ACOs from both the patient and provider perspectives? One of the goals of the Affordable Care Act (ACA) is to provide coordinated care which, in turn, increases quality and efficiency within the healthcare field, and reduces costs. ACOs – What is an ACO? ACOs are groups of providers which form an organization based upon the Medical Home (or PCMH) concept. The Medical Home places responsibility for the coordination of care with the primary physician. The primary care physician coordinates with other physicians and providers such as specialty physicians, laboratories and diagnostic imaging, providing a central point for the patient’s medical information.

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Health Care Reform