The American Hospital Association steps in; the American Medical Association steps up.On Sept. 27, 2017, the Centers for Medicare & Medicaid Services (CMS) announced that it would not update its overall hospital quality star ratings in October 2017, as planned. This was primarily based on the public's feedback, but the…
While most legacy CDI programs have been doing a good job at preserving revenue under the MS-DRG system, a potential blind spot exists as Value-Based and Alternative Payment Models rely on the concept of Risk Adjustment to determine final payment in acute care. The Centers for Medicare & Medicaid Services risk…
In the final rule for the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) PPS for the 2017 fiscal year, the Centers for Medicare & Medicaid Services (CMS) continues to move the Medicare program toward paying providers based on the quality, rather than the quantity, of care…
EDITOR’S NOTE: This is the final installment of a two-part series that examines episodes of care as healthcare payment model. Part I was published on July 19, 2016. The financing of healthcare is rapidly changing in this country. The Centers for Medicare and Medicaid Services (CMS) has introduced a wide array…
EDITOR’S NOTE: This is the first in a two-part series that examines episodes of care as healthcare payment model. Part II will be published on July 26, 2016.The financing of healthcare is rapidly changing in this country. The Centers for Medicare and Medicaid Services (CMS) has introduced a wide array…
Health plans nationwide are touting widespread success in the implementation of ICD-10, according to comments made by three health plan representatives during the most recent edition of Talk Ten Tuesdays, the weekly Internet broadcast hosted by ICD10monitor.com.
After two months of working full-time with ICD-10-CM/PCS, what do we know about the success of providers’ transition efforts? In general, it’s too early to tell. It will likely be 90 to 120 days from implementation before we have solid revenue cycle data to determine the financial impact of ICD-10.…