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Sept. 16, 2019 / By Cheryl Manchenton, RN
As I mentioned in my previous blog, the sign of the times in health care can often be reflected in the proposed (and confirmed) new electronic Clinical Quality Measures (eCQMs). […]
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Sept. 9, 2019 / By Cheryl Manchenton, RN
I have to confess I am starting to show my age. When someone mentions sign of the times, I think of Petula Clark Sign of the times, not the Harry […]
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Sept. 6, 2019 / By Barbara Aubry, RN
In case you missed the release of the Medicare Learning Network (MLN) Matters article SE19012 on June 27, 2019, I wanted to share some insights for all the compliance folks […]
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Aug. 26, 2019 / By Samuel Young, MD
In my previous blog, “Demystifying Medicare Risk Adjustment,” I introduced the model that the Centers for Medicare and Medicaid Services (CMS) uses to predict future Medicare Advantage health expenditures—the CMS-HCC […]
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Aug. 23, 2019 / By Gretchen Mills
In 2011 the first 32 Medicare ACOs were announced under the CMS Pioneer ACO program. Since then, CMS has made multiple modifications to the program. Initially, most organizations chose to […]
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Aug. 16, 2019 / By Karla VonEschen, MS, CPC, CPMA
Can you feel change in the air? Not only is fall just around the corner, but so is the CMS change to E/M documentation and payment. By now, most of […]
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Aug. 14, 2019 / By Barbara Aubry, RN
For those involved in coding and compliance, this is not the first time attempted changes to E/M rules have been proposed. Remember 1995 and 1997? Of course, I’m way too […]
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Aug. 7, 2019 / By Steve Delaronde
A proposal was issued by the Centers for Medicare and Medicaid Services (CMS) on July 29, 2019 stating that hospitals must make public the payer-negotiated price for 300 common shoppable […]
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Aug. 5, 2019 / By V. “Juggy” Jagannathan, PhD
This week’s AI Talk… FHIR on fire Fast Health Interoperability Resources (FHIR), pronounced as “fire,” is HL7 healthcare interoperability standards specification. Early in 2019, ONC and CMS signaled that they […]
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July 26, 2019 / By Karla VonEschen, MS, CPC, CPMA
After attending an AAPC presentation last year, I published a blog about HCC coding. Since then, I have continued to dive into the world of HCCs. To follow up on […]
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July 24, 2019 / By Richard Fuller, MS
Risk adjustment is a correction applied in hospital performance measurement to account for the contribution of population characteristics that are beyond the control of the hospital. The effects of these […]
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July 17, 2019 / By Barbara Aubry, RN
The country is revving up for the next election cycle. Like it or not, health care is a focus again and some sword-rattling is taking place regarding the IPPS (Inpatient […]