Services Archives - Page 20 of 32 - BHM Healthcare Solutions

Top 8 ACA Delays |Blatantly Illegal or Temporary Courses of Action?

2017-04-02T13:28:34-04:00By BHM Marketing|Compliance, Health Care Reform, Health Insurance, Health Insurance Exchange, Services|

With so many ACA delays thus far, is the ACA really what we bargained for? Should the President have the authority to delay ACA provisions at his discretion or is it his duty to uphold the law as written? The Affordable Care Act was enacted in 2010 with provisions becoming effective over several years, many of which have been delayed. Why the ACA delays? •Limited resources for implementing the law •The need to prioritize limited resources •Technological limitations, such as the “glitches” in the computer systems as they related to the healthcare exchanges •Complaints from various quite vocal groups, both political and non •Undue hardships placed on employers and / or employees •Additional time and / or funding required to comply •Tax and reporting requirements •Political reasons

Good Medicine Is More Than an HCAHPS Score

2017-04-02T13:28:34-04:00By BHM Marketing|Clinical Analysis, Clinical Operations Improvement, Quality Improvement Programs, Services|

Improving patient satisfaction is a laudable and necessary goal for any hospital, particularly when revenue is at risk based on patients’ opinions regarding quality of care. But patient satisfaction measures should not be confused with good medicine – a nobler objective that delivers richer results. Scores on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) can bring bonuses to hospitals that do well on the survey. Those that don’t may risk losing some Medicare funding under the Hospital Value-Based Purchasing Program. So it’s understandable that hospitals care a great deal about HCAHPS. But the survey scores should not be seen as a proxy for good medicine.

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.

8 Healthcare Provider Pain Points | What Are Your Pain Points?

2017-04-02T13:28:36-04:00By BHM Marketing|Clinical Analysis, Financial Analysis, Operational Analysis, Services|

What are your healthcare provider pain points? What are you doing to overcome them? What advice can you offer your colleagues? From a provider perspective, healthcare, as we know it, is changing rapidly. At times your head might be spinning when you think about the impacts of the Affordable Care Act as well as other healthcare legislation. How can you be sure the priorities you have established will help you comply and meet all established deadlines? What do you feel are the most critical pain points you are facing? You may be a physician’s office, you may be a hospital or healthcare system, you may be a rehab facility. All of these providers are experiencing similar issues, which vary from one degree to another. Let’s delve into a few of these.

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.

5 Healthcare Payer Pain Points | What Are Your Pain Points?

2017-04-02T13:28:37-04:00By BHM Marketing|Clinical Analysis, Financial Analysis, Organizational Analysis, Services|

As a payer, what type of pain points are you facing? How are you overcoming these challenges? With the onset of the ACA and other healthcare regulation, payers are experiencing many issues. Complying with these regulations is both cumbersome and costly. What pain points are you experiencing as a payer? Exchanges Healthcare exchanges became effective October 1, 2013. These exchanges are basically marketplaces where individuals can shop for insurance in one place - comparing plans, costs, and benefits. Many payers jumped on the bandwagon and joined the exchanges.

10 Reasons Your Claim Was Denied

2017-04-02T13:28:37-04:00By BHM Marketing|Financial, Health Insurance, Services|

There are many reasons a claim might be denied, but did you know that many of them are actually simple oversights that can easily be corrected? Check your denials against this list to see how many preventable errors might be costing your hospital money.

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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