Articles Tagged With: CMS
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CMS, HHS Offer Multipronged Approach to Improving Maternal Health
Biden administration asks hospitals to review policies and procedures, calls on states to expand postpartum coverage under Medicaid and CHIP.
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Latest Leapfrog Safety Grades Include Post-Op Sepsis
The most recent grades from The Leapfrog Group represent the largest set of hospitals ever evaluated, with grades assigned to 2,901 facilities. More than 30 evidence-based measures of patient safety were assessed, including postoperative sepsis, blood leakage, and kidney injury for the first time. -
CMS Warned of Mandate’s Threat to Long-Term Care, Rural Sites
Even healthcare workers who are fully vaccinated against COVID-19 voluntarily warn of the unintended consequences of a federal vaccine mandate, particularly to long-term care and rural facilities already hit hard by the pandemic.
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CMS Issues Mandatory Vaccine Rule for Healthcare Workers
While emphasizing the national threat of the pandemic and the safety and efficacy of the SARS-CoV-2 vaccines, the Centers for Medicare & Medicaid Services came down to one bedrock reason healthcare workers now face mandated immunization: their ethical duty to protect patients.
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CMS Requires COVID-19 Vaccinations for Healthcare Workers
The Centers for Medicare & Medicaid Services’ highly anticipated interim final rule requiring healthcare workers to be vaccinated against COVID-19 will bring new obligations for healthcare employers, but it also might help overcome the objections of some employees.
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Medicare Sepsis Performance Measure Criteria Do Not Improve Outcomes
A longitudinal study of a single health system’s adherence to and outcomes of Medicare Sepsis Performance Measures (SEP-1) did not show an improvement in mortality despite improvements in adherence to guideline-mandated care.
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Case Management at the Entry Points: Ensuring Reimbursement Through Appropriate Surveillance
At a time when capacity and reimbursement are more important than ever, case managers play a key role in helping operations run smoothly. One way this happens is through monitoring the entry points of the hospital. These points include the emergency department, post-anesthesia care unit, direct admission to the units, or transfers from other facilities. This is not to say case managers should now add “security guard” to their extensive list of roles and tasks; rather, they are uniquely positioned to survey the whole picture, including how entry points are used. -
CMS to Issue Rule Mandating Vaccines for Healthcare Workers
President Biden has dropped the carrot and picked up a stick, ordering healthcare workers — all 17 million — to receive the COVID-19 vaccine, or Medicare money may be withheld from their employers. -
Best Practices for Managing Denials
When denials occur, case managers should create a plan to investigate and manage each one to determine why the claim was denied and how they can help. Using this approach, some managers have uncovered trends and root causes that can prevent future denials. It is critical for case managers to hone this skill for the benefit of the patient and the hospital. -
A Hospital at Home Program and the Role of the Care Management Team
For many healthcare systems, a hospital at home program was a necessity born out of COVID-19. At Indiana University Health, a program that allowed patients to continue treatment and recovery at home after discharge had been discussed before the pandemic, but never put into action. That changed when the pandemic started. They went forward with the program, knowing it was the right time to try it.