Services Archives - Page 23 of 32 - BHM Healthcare Solutions

How Are You Using Physician Data Mining?

2024-06-26T10:46:45-04:00By BHM Marketing|Big Data, Financial Analysis, Physician Compensation, Services|

The pay for performance model of payment has been the preference of health insurance companies for several decades. Previous models made it too easy for money to be paid for services that were not truly needed, were poorly documented or in some cases, were entirely fabricated for the purpose of payment. Pay for performance measures are meant to validate payments to physicians in accordance with The Affordable Care Act by using data mining techniques to keep tabs on physician costs.

Do Patient Satisfaction Surveys Help or Hurt Reimbursement?

2017-04-02T13:28:40-04:00By BHM Marketing|Financial Analysis, Healthcare Preventitive Care, Medicare and Medicaid, Physician Compensation, Services|

The “patient is always right” model has been the primary driving force behind healthcare for the last several decades. But is this the right approach? Classifying patients as “customers” is a slippery slope. While you might be able to barter with a customer at a shop about the price of a necklace, should doctors ever barter with a patient about their treatment? What about when their patient satisfaction scores are drooping low?

The Cost of Resistance | Clinical Coding Optimization

2023-07-28T14:53:42-04:00By BHM Marketing|Financial, Financial Analysis, Medicare and Medicaid, Physician Compensation, Services|

Physician practices may be lagging behind hospitals when it comes to implementing coding software. The hesitation to do so is costing them not only efficiency in coding, but reimbursements withheld due to avoidable errors.

Bundled Payments | Rewarding Quality and Value

2017-04-02T13:28:40-04:00By BHM Marketing|Care Coordination, Financial Analysis, Health Care Reform, Services|

Summary: The healthcare industry is transforming from fee-for-service to value-based payment systems. One of the fairly new forms of reimbursement to hit the streets is bundled payments. Overview of Bundled Payments The Medicare reimbursement system is in the process of transforming healthcare as we know it from a traditional fee-for-service model to a system that rewards based on quality, care coordination, accountability, and healthcare cost savings.

Healthcare Buzzwords: What is Big Data?

2024-06-12T10:29:06-04:00By BHM Marketing|Big Data, Health Care Reform, Services|

The term “Big Data” has only recently entered the healthcare and medicine verbiage. It used to be largely reserved for the larger-than-life scientific research that spanned the entirety of the universe. It’s no surprise that the concept of Big Data has translated nicely to the universe inside of us.

ICD-10 Delay: Does ICD-10 Lack Clinical Value?

2023-07-28T14:38:28-04:00By BHM Marketing|Big Data, Clinical Analysis, Clinical Operations Improvement, Compliance, Medicare and Medicaid, Services|

ICD-10 was delayed once again as part of a bill that was meant to fix the physician reimbursement issues with Medicare. The ICD-1o delay was merely a footnote in a jam-packed bill that was going to make many doctors very happy; incidentally, pushing out the date for ICD-10 implementation also pleases many physicians. Some have gone so far as to say, on record, that ICD-10 lacks clinical value.

Understanding RVUs | Medicare Reimbursement

2017-04-02T13:28:40-04:00By BHM Marketing|Financial, Financial Analysis, Physician Compensation, Services|

Summary: Do you understand Relative Value Units (RVUs) as they relate to Medicare reimbursement? Is your physician compensation model based upon RVUs or a derivative thereof? What is an RVU? RVU stands for Relative Value Unit and is currently used by Medicare to determine the amount of reimbursement to providers. RVUs are basically a way of standardizing and comparing service volumes across all continuums.

Hospital Acquired Infections: The Diagnosis That Could Have You Paying an Extra $40,000 Per Patient

2017-04-02T13:28:41-04:00By BHM Marketing|Clinical Operations Improvement, Financial, Healthcare Preventitive Care, Quality Improvement Programs, Services|

Hospital Acquired Infections (HAIs) occur when a patient is exposed to a bacterium, virus or fungi during their hospital stay that leads to an additional condition. These additional conditions can cost hospitals thousands of dollars in lost revenue.

Observation Units – Bridging the Gap Between Inpatient and Outpatient

2017-04-02T13:28:41-04:00By BHM Marketing|Clinical Operations Improvement, Financial, Health Insurance, Readmissions, Services|

What is CMS doing to reduce healthcare costs? CMS has added observation units which are an additional level of care between inpatient and outpatient. What Are Observation Units? In general, observation units are used to bridge the gap between inpatient and outpatient. They are designed for the patient in which the attending physician cannot determine whether a patient should be classified as outpatient (released within 48 hours) or inpatient (expected to stay at least 2 midnights). The observation units enable the physician to have a bit more time to stabilize the patient and based on medical necessity determine the estimated length of stay. They are billed as outpatient and do not count toward an inpatient admission.

Yay or Nay on the ICD-10 Delay?

2017-04-02T13:28:41-04:00By BHM Marketing|Big Data, Compliance, Medicare and Medicaid, Services|

Yesterday the House of Representatives voted on a bill that included a proposal for delaying the implementation of ICD-10 for another year, bringing the compliance date to October 2015. Hospitals nationwide are in the throes of gearing up for the implementation deadline in October of this year, a mere six months away. While some who are not in healthcare may view the delay as a sign of relief, those who have been spending time and money on the implementations are not sighing so much as groaning at the possibility of pushing the deadline out further.

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