The Centers for Medicare & Medicaid Services released the final version of its hospital quality ratings Wednesday and posted them to the Hospital Compare website. Many of the most well-known hospitals in the nation received below average scores while lesser known facilities took the top scores.
Free Webinar: Beyond Concordance Rates: BHM’s New Innovations for Improving the Peer Review Process BHM Healthcare Solutions debuts its exciting new web-based suite of data reporting tools! BHM is at the forefront of data mining allowing clients to do a deeper dive on case data. Unlike any other reporting tool in the market today, BHM’s peer review system facilitates more data capture, data mining - analysis, reporting and review. Managing your case data more effectively will reduce costs, improve productivity, and maximize your resources.
The Centers for Medicare & Medicaid Services (CMS) has been pushing value based models that focus on quality of care rather than quantity. This means that most traditional incentive based payment models are being put phased out. The CMS hopes to tie 90% of all Medicare payments to alternative payment methods by 2018. Unlike fee-for-service models, value based models tie quality and cost together. By doing this they can encourage providers to give the best possible care at the best possible cost.
The nation’s addiction to prescription painkillers is hovering at epidemic levels. The CDC reported that in 2014 more than 14,838 people died from overdoses of drugs such as oxycodone. (cite). Providers are now forced to think of new and innovative ways to help stop the epidemic, which is tied closely to the opioid epidemic. Telemedicine has become a huge savior for many rural areas trying to fight drug related deaths and conditions.
The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool used by 90% of the United States’ Health Plans to measure performance on important elements of care and service. HEDIS standardizes the way health plans collect, analyze, and report data. It creates an equal playing field for all health plans (who use HEDIS) to be compared. It also can be used by employers, consultants, and patients to find the best health plan match for their needs. Many payers are now using value based reimbursement models to help meet HEDIS benchmarks. These value based programs make providers accountable for closing gaps in care and meeting HEDIS measures.
On September 22, 2016 the NCQA announced the release of the 2016-2017 Health Insurance Plan Ratings, this is the second year of the NCQA's new rating methodology. The Health Insurance Plan Ratings. which are published annually and compare the quality and services of more than 1,000 health plans across the United States. One new aspect of the 2016-2017 ratings is that WebMD will be publishing the ratings on their WebMD.com.
Thanks to The Excellence in Mental Health Act (ExACT) passed in 2014, it’s predicted that 2016 will be a big year for Behavioral Health. As the country takes critical steps towards moving Behavioral healthcare off the back burner, demand for these services continues to grow. This will result in ample opportunity for organizations diving into Behavioral Health or BH Integration to champion the cause in 2016. But it’s important to remember that the impact of Behavioral health moves across the care continuum.
Choosing the right Peer Review Program can be difficult. It’s important to look for a Peer Review Program that distinguishes itself through quality work, ongoing training, full compliance, and the latest technology. You want to trust the organization you choose and make sure they are industry certified. Use these 5 tips to help you choose a Peer Review Program or use as a guide for your current vendor.
According to the Centers for Disease Control, an estimated $25 billion of U.S. healthcare costs was attributed to the abuse of painkillers—otherwise known as opioids. Up to 36 million people worldwide struggle with opioid addiction. It is a real concern for health plans and the pharmacies and providers under their umbrella. How can your health plan read the warning signs within provider networks to prevent this addiction from the start and minimize the risk and cost impact to your organization?
Three data security stories caught my eye, this month. August 3: Banner Health suffers year's largest data breach; 3.7M affected August 15: Bon Secours vendor breach affects 655k patients August 22: OCR to investigate more breaches affecting 500 or fewer individuals As much as the details differ between the three stories, one worry comes true: cyber security threats are growing.