ICD-10 Readiness
Final preparations are underway to minimize healthcare industry disruptions as the ICD-10 cutover draws near. Success stories surrounding ICD-10 adoption shine a positive light on this transition, but there are still concerns surrounding these final stages of change. Identifying the key readiness risks and working together to address these concerns will help ensure a seamless transition for each HIPAA-covered entity and warranty success. Key ICD-10 Readiness Risks Provider compliance to ICD-10 and willingness to code accurately: the primary driver to...
The FY 2016 Inpatient Prospective Payment System Final Rule Reinforces CMS’ Move from Volume to Value By Emily Richmond, MPH
On August 17, 2015, the Centers for Medicare and Medicaid Services (CMS) issued its final rule for the Inpatient Prospective Payment System for fiscal year 2016. The rule serves to reinforce the increasingly swift pace CMS is taking to move towards a value-based payment system. This rule also demonstrates that there will continue to be a lot of moving parts for hospitals and other inpatient facilities to keep track of over the next few years - from changing quality measures...
Practical Approaches to Enhance Care Transitions into the Community By Shanti Wilson
As seen in Becker’s Hospital Review. Enhancing care transitions requires involvement from all members of the care team. From the provider to the patient, practical approaches to advancing communication and data are key for improving outcomes and quality of care. Health education, community-based organizations (CBOs), soft handoffs, nurse case managers, and shared action plans can all enrich care transitions and lead to improvements throughout the care continuum. By focusing on data and analytics and finding gaps...
Consumer-Driven Health Plans Require Effective Price Transparency Tools By Elyse Ruiz
Today, more and more consumers are enrolling in high-deductible health plans (HDHP), also known as Consumer-Driven Health Plans (CDHP). According to the Institute on HealthCare Consumerism, “More than one in five Americans with private insurance is enrolled in a high-deductible health plan, [with an average] deductible over $1,000.” For many Americans, HDHP enrollment allows consumers to reduce premiums and avoid over-insurance, and is a viable alternative to the traditional HMO and PPO healthcare plans. The spike in CDHPs is understandable;...
Need to Know: Key Provisions in the 2016 Medicare Physician Fee Schedule Proposed Rule By Emily Richmond
The Centers for Medicare and Medicaid Services (CMS) has released the 2016 Medicare Physician Fee Schedule proposed rule, the first proposed fee schedule updates since the repeal of the Sustainable Growth Rate (SGR) formula by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The 2016 Medicare Physician Fee Schedule proposals reflect a focus on quality program-specific provisions, and align with CMS and Congress’ stated intent to continue shifting the Medicare program towards a system that rewards high-quality care...
CMS And AMA Come Together To Help With ICD-10 Transition
The ICD-10 transition is coming fast. Even though summer is in full swing, we can feel the first hints of fall, and with it, the October 1st deadline to transfer from ICD-9 to ICD-10. This has the potential to be confusing for providers and administrators, but luckily, the Center for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) have come to an agreement in mutual support for transitioning to ICD-10. This is good news for everyone involved,...
Addressing The Main Issues That Impact Care Coordination At The 2015 Technology Forum By Samir Panchal
The Health Technology Event on June 25th, 2015, brought together healthcare industry experts to discuss the main issues impacting Care Coordination in today’s healthcare system. Samir Panchal of Freed Associates moderated this event, seeking out new ideas for integrating health services and technology with a focus on patient-centered care. Discussions centered on the three main points of data integration, communication, and patient privacy. Samir Y. Panchal, Management Consultant at Freed Associates has...
Commercial ACOs: Ten Questions To Ask Yourself Before Diving In By Sylvia Dochterman
The Affordable Care Act (ACA) has spawned a rise in Accountable Care Organizations (ACOs)—both private commercial ACOs and public sector ACOs—in recent years. This proliferation largely resulted from an ACA provision regarding traditional Medicare Fee-for-Service (FFS) programs. The provision required providers to organize as ACOs if they wanted to benefit from new shared-savings programs and value-based incentives. Many private commercial payers have since jumped onto the ACO bandwagon, and your organization may be considering doing the same. Before you follow suit,...
ICD-9 to ICD-10: Keeping Revenue Cycles on Track During Transition
By October 1st of 2015, organizations governed by HIPAA are required to transition from ICD-9 to ICD-10, an exponentially more complex medical coding system than its predecessor. This switch can pose many challenges for provider revenue cycle and payer claims processing, as some healthcare providers and insurance carriers struggle to meet the new requirements. Fortunately, there are things you can do to prevent the wheels of your organization from grinding to a halt post implementation. By closely monitoring four...
Healthcare Price Transparency: Is Your Company Meeting Consumer Expectations? By Carly Dunham
In today’s era of consumerism, companies like Amazon get it. They empower shoppers to compare prices, read reviews, and they deliver purchases straight to your door. Healthcare has some catching up to do, especially when it comes to healthcare price transparency, quality transparency, and consumer engagement. As American consumers, we expect our shopping experience to be easy—no matter what we’re looking to buy. We favor businesses that practice transparency and provide high-quality, cost-effective products, and we take greater pride in...
Project Management Fundamentals: Have You Mastered The Basics? By
In my 25 years of leading and overseeing projects in the healthcare industry, I’ve developed an understanding of what makes a project successful. It starts with a bit of luck — luck in having a committed sponsor, a dedicated team, and a realistic budget and schedule. It requires the ability to lead, motivate, influence, and direct that team to deliver results. Most importantly, it requires an understanding of the project management basics, or fundamentals, and the ability to execute these...