Transparency is not just a regulatory requirement for healthcare payers; it’s a key factor in fostering trust, improving relationships, and driving collaboration. By focusing on clear communication, data integrity, financial openness, and regulatory compliance, payers can create a more reliable and cooperative environment with providers.
Medical directors face novel legal risks for professional liability, regulatory compliance, licensure board complaints, and careless communication habits. A more thoughtful understanding of the distinct obligations and potential medical director legal risks may help medical directors and their employers avoid unnecessary stress and minimize the chances of legal entanglements.
Health reform puts healthcare organizations at more financial risk than ever for care costs and quality, both inside and outside their workplace. But it doesn't change the fundamental fact that physicians, even employed physicians, remain the final arbiters of what care actually is provided. CMO responsibilities evolve with need and business acumen grows as a vital need.
The Medical Director role takes on a dramatic evolutionary shift in responsibility and scope due to healthcare reform (and re-reform) and an industry which is now focused on efficiently driven quality care.
As healthcare continues to change, so do some of the roles within the industry, but no role has perhaps experienced a shift quite as significant as the Medical Director. This position has taken on a dramatic evolutionary shift in responsibility and scope. The roles and responsibilities now require stretching medical director skills into contract negotiations, group dynamics, organizational development, team management, and many areas not covered in a traditional medical curricula.
BHM's webclinic “Components of a Great Peer Review Program” goes live Wednesday, November 18th from 12:00pm to 1:00pm EST. You don't want to miss this great opportunity to receive expert advice related to Peer Review Services. Don't worry you still have time to sign up!
Lately we have been talking about the important of Independent Review Organizations (IROs) and peer reviews in the healthcare ecosystem. Today we continue this discussion and delve deep into the importance of the peer review process. We know that peer reviews are a crucial part of healthcare because they hold medical professionals and organizations accountable in addition helping to build a world of trust between patient and physician. The peer review process is one that consists of high levels of property technology and superior customer service. By boosting transparency in healthcare, peer reviews have become an essential standard helping to make healthcare safer and more efficient. So let’s take a look at the 5 core building blocks of the peer review process.
The National Committee for Quality Assurance (NCQA) is searching for early adopters of its newest delivery system evaluation program, the Patient-Centered Connected Care Recognition (PCCC).
With HIPAA Phase 2 audits looming on the horizon, many organizations are gearing up for the audits with internal assessments. We've already talked about how your organization might be unwittingly violating HIPAA, but what penalties are you really facing?
With all this talk about making patient records more accessible to care teams via the magic of the electronic record, HIPAA and HITECH— the two laws that govern patient privacy — might seem like a bit of a downer. They serve a very explicit purpose, however, and ensuring that you are always in compliance will not only save you legal woes, but money in the form of fines and penalties for breaches. There are some obvious breaches of confidentiality that we must strive to avoid: you would never, for instance, post to all your Facebook followers the name, diagnosis and prognosis of a particularly difficult patient that you had today. What you might do instead, though, is go home and tell your spouse all about it. That’s a HIPAA violation.