Uncategorized Archives - Page 8 of 25 - BHM Healthcare Solutions

Health Plans Create Best Practices: New Opioid Crisis Report

2017-07-25T16:06:19-04:00By Eric Duchinsky|Uncategorized|

Health plans create best practices and lead with concrete strategies for preventing opioid overuse. The Association for Community Affiliated Plans (ACAP) recently issued a report detailing the innovations and best practices of its member Health Plans in their efforts to combat opioid misuse and overuse. The opioid epidemic led to an estimated 33,000 deaths and more than 300,000 emergency room visits in 2015, and recognized as a subject of intense debate on Capitol Hill and in statehouses around the country.

Health Systems Financial Futures at Risk: New National Survey Results

2017-07-20T16:33:42-04:00By Eric Duchinsky|Uncategorized|

According to a new report, prominent factors are challenging small hospitals and health systems financial futures and notes organizations can address these obstacles through a transformation leading to a competitive advantage and better health outcomes for patients.

5 Medical Cost Pressures Shaping 2018

2017-07-11T18:11:23-04:00By Eric Duchinsky|Financial, Financial Analysis, Health Insurance, Revenue Cycle Improvement, Trends, Uncategorized|

The era of volatile swings and double-digit growth in employer medical costs appears to be ending. With medical cost trend hovering in the single digits for several years, the industry has been waiting for the inflection point when spending will take off. But that spike appears unlikely to happen. The New Health Economy is settling into a “new normal,” typically characterized by more attenuated fluctuations and a single-digit trend.For four years, medical cost trend has hung between 6 and 7 percent, seeming to settle into a “new normal.” PwC’s Health Research Institute (HRI) anticipates a 6.5 percent growth rate for calendar year 2018, half a percentage point higher than in 2017.

Shoveling Money Down Growing Behavioral Health Gaps?

2017-06-13T19:54:09-04:00By Eric Duchinsky|Uncategorized|

Calculating future expenses stresses all managers and directors. In the ever-changing world of healthcare, making the time to accurately budget costs can cause headaches, nausea, dizziness, and palpitations. (Please do not operation heavy machinery while thinking about budgets.) Estimating the financial impact of the growing behavioral health gaps may be the final straw. Today's blog gathers data points from recent studies, reports, and presentations from around the healthcare industry and offers a starting point for your various budget models. Make the time to verify your models are sporting the most current data. Challenge your assumptions, because margins are thin and getting thinner.

Top (and Bottom) 10 States For Behavioral Health Staff Shortages

2017-05-31T20:18:20-04:00By Eric Duchinsky|Behavioral Health Integration, Clinical Operations Improvement, Uncategorized|

The greatest need for mental health professionals are found in the more populated east coast and remote northern states. Large populations and rural settings significantly impact behavioral health staff shortages. The Health Resources and Services Administration (HRSA) released the most current data. The table shows the 10 states with the worst behavioral health professions clinical coverage, the national average, and the 10 states with the best BH coverage.

Top 5 Largest Health Plans in the United States

2017-04-25T23:07:46-04:00By Eric Duchinsky|Financial Analysis, Revenue Cycle Improvement, Trends, Uncategorized|

The largest health plans share more things in common than you might imagine. Striving for the high quality patient care comes to mind. How about striving for process efficiency? Absolutely. Integrating continuous improvements move these organizations ahead of the rest.

Medical Loss Ratio: Updates and Impact

2017-04-18T20:46:47-04:00By Eric Duchinsky|Financial, Financial Analysis, IRO, Physician Advisor/Peer Review, Uncategorized|

Healthcare spending is on the rise. The federal government has begun several initiatives to control costs, increase efficiency, and increase quality. Revisiting one of the ACA, Medical Loss Ratio.

Levels of Care Impact Medical Necessity Review Success

2017-07-05T17:19:34-04:00By Eric Duchinsky|Accreditation, Services, Uncategorized|

Level of Care Guidelines are usually derived from generally accepted standards of behavioral health practice. These standards include guidelines and consensus statements produced by professional specialty societies, as well as guidance from governmental sources such as CMS’ National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs).

Behavioral Healthcare Shortages: Causes and Solutions

2017-07-05T17:13:36-04:00By Eric Duchinsky|Behavioral Health Integration, Clinical Analysis, Clinical Operations Improvement, Uncategorized|

The National Council for Behavioral Health and the National Council Medical Director Institute released a far-reaching report this month: The Psychiatric Shortage: Causes and Solutions. As a recognized leader in behavioral health reviews, this BHM Healthcare Insider Blog brings selections from the executive summary focusing on the behavioral healthcare shortages and solutions.

Successful Delegation To Downstream Entities

2018-05-23T16:25:27-04:00By Eric Duchinsky|Compliance, Operational Analysis, Uncategorized|

Healthcare organizations face challenges regarding reduction of their medical and administrative costs because regulatory and administrative demands are increasing. Payers and providers must evaluate new partner relationships and solutions for work processes and potentially outsource administrative functions in order to offer competitively priced services to patients. Successful delegation requires planning.

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