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Scooped by Jim Brule onto Healthcare Now |
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In a federal lawsuit, the American Hospital Association and four healthcare providers accuse HHS of illegally denying hospitals Medicare payments for audited outpatient procedures.
The Chicago-based interest group for hospitals says in the complaint that HHS maintains an illegal policy of refusing to pay hospitals for Medicare outpatient services in cases where auditors retroactively conclude that inpatient care should have been delivered outside the hospital.
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Scooped by Jim Brule |
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The Medicare Payment Advisory Commission suggested in a four-page letter to CMS this week that the performance of providers involved in the renal-specific Accountable Care Organization demonstration should be judged on not only standard quality...
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Scooped by Jim Brule |
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The Office of the National Coordinator for Health IT continues to support health information exchange in Stage 2 of the Meaningful Use program, recently releasing a document to help health information organizations support the transition of care...
This is a flawed measure. It requires the transmitter to verify that the message was received, but there is no reliable method for doing this. ONC acknowledges this in its guidance, and says that vendors can declare that they believe it works. This will be an auditing nightmare...
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Scooped by Jim Brule |
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Providers are beginning to sound alarms that some payers aren't providing adequate or high-quality claims data, making that information unusable.
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Scooped by Jim Brule |
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Patients' active, thoughtful self-care and investigation online should not only be commended, it should be celebrated, integrated and prioritized.
Pithy quote: "Imagine U.S. health care if communication was as important as the technology."
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Scooped by Jim Brule |
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Six good principles for pursuing stage 2, beginning with "Don't ignore the human side."
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Scooped by Jim Brule |
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Hospitals can make more money when surgery leads to complication that need to be fixed. Critics say the current payment system rewards hospitals for bad care and fails to provide incentives that would benefit patients.
It's always important to watch the incentives ... and the unintended consequences of intervention!
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Rescooped by Jim Brule from EHR Success |
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Is the outlay for a PHM worth it? Quality incentives and bonuses can offset the annual cost in 1 to 3 months.
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Scooped by Jim Brule |
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When it comes to spending, some states may get more bang for their buck.
Great data!
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Scooped by Jim Brule |
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The Centers for Medicare and Medicaid Services has published guidance on Medicare electronic health records meaningful use audits being conducted by its contractor, Figliozzi and Company.
Critical links in this article on how to prepare for an audit with best practices.
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Scooped by Jim Brule |
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According to the Centers for Medicare & Medicaid Services (CMS), Meaningful Use audits will be conducted on 5 to 10 percent of eligible professionals
The latest wrinkle: "Pre-payment audits" - in which you must survive an audit before you can be paid.
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Scooped by Jim Brule |
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Five Tennessee healthcare organizations have joined a pilot project to exchange information using the federally developed Direct secure-messaging protocol.
The adoption of the Direct protocol is a critical challenge for the nation's HIT infrastructure.
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Scooped by Jim Brule |
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A new fight is brewing over health insurance companies letting millions of Americans renew their current coverage for another year — and thereby avoid changes under the federal healthcare law.
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Scooped by Jim Brule |
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Use of the words "audit" and "Medicare" in the same sentence tend to make even the most seasoned physician uncomfortable.
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Scooped by Jim Brule |
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There are overwhelming monetary incentives for physician-owned hospitals to market to the healthiest and wealthiest, who seek a narrow list of procedural interventions. But then those physicians are rewarded with value-based payments for high satisfaction scores and low readmission rates as mandated by the Accountable Care Act.
What happens to the rest of the patients—the ones with one if not several chronic conditions and minimal if any insurance?
They find their way to teaching hospitals, which treat a disproportionate number of “dual eligibles.”
Joanne Conroy, MD, is Chief Health Care Officer at the Association of American Medical Colleges.
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Scooped by Jim Brule |
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A long, loud screaming campaign against Obamacare ends in a quiet whoops.
One of a series of articles advancing the possibility that healthcare reform is actually starting to work, despite WSJ's pessimism.
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Scooped by Jim Brule |
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AMA chair Steven Stack, MD said that some Medicare carriers have already issued rules that if patient charts look too similar, they will deny payment for them.
A great article! It highlights the Catch-22 from CMS and payers to be both consistent and different, as well as many other challenges as we continue this transition to information technology.
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Scooped by Jim Brule |
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Hospitals and health systems need metrics to determine their progress in moving toward a pay-for-performance model.
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Scooped by Jim Brule |
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President Obama said Tuesday that his healthcare law is bound to hit some snags as it comes fully into place over the next six months.
The biggest challenge - no big surprise! - will be healthcare information exchanges.
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Rescooped by Jim Brule from EHR Success |
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Scooped by Jim Brule |
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Incentive checks could be delayed if a physician's electronic submission is flagged for possible problems, or chosen at random for review.
They are also being applied if you don't do well on an audit...
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Scooped by Jim Brule |
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The AHA has highlighted obstacles and flaws to reporting clinical quality measured electronically presented by the EHR Incentive Programs (i.e., meaningful use).
In a letter dated April 8, AHA Vice President and Deputy Director of Policy Ashley Thompson has urged CMS to reconsider its approach to reporting CQMs via the Physician Quality Reporting System and the EHR Incentive Programs based on a lack of necessary infrastructure.
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Scooped by Jim Brule |
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Proposed meaningful use exemptions are hailed as a potential boon for some providers, but will a new bill in Congress help bring changes?
The idea is to allow exemptions for providers aged 54 and older; there is no mentioned penalty for claiming the exemption and then not retiring. FAIL.
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Scooped by Jim Brule |
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ONC is encouraging states to join the State Meaningful Use Acceleration Challenge 2.0 and set goals on EHR adoption and meeting Meaningful Use criteria. Learn more.
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Scooped by Jim Brule |
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Illinois has been one of the most aggressive states in the implementation of the Affordable Care Act (ACT). So far, the State of Illinois has pocketed $200 million from the ACA.
The administration of Governor Pat Quinn has implemented multiple changes to Illinois healthcare.
A good review!
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Scooped by Jim Brule |
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Implementing electronic records and meeting Meaningful Use rules are top of the list in our Health IT Priorities survey. Is there room for breakthrough technology?
Regualtions are turning the foundations of HIT into commodities. This marks the latest development in the painful but critical transition to the use of information technology in the healthcare sphere.
"Most healthcare CIOs are supportive of the majority of the new functional requirements that are being forced on them. However, federal requirements are coming too many, too fast. … The rate of change is such that systems and changes are being implemented less than optimally."
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