Articles Tagged With: CMS
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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. -
How to Help Patients with Limited English Proficiency
As with many other unfunded federal mandates, interpretation services in hospitals face a variety of resource challenges, including insufficient staff training, too few interpreters, and cumbersome technological solutions. To surmount communication barriers, case managers and other healthcare professionals should pay attention to language access, such as interpreters and translations, usable health information (which is eliminating medical jargon), and cultural humility. -
Billing Records Audits Require Prompt, Thorough Responses
A government billing records audit will make most hospital leaders nervous because of the potential financial — and even criminal — consequences, but understanding the process and best practices can alleviate the stress. -
Parents Still Unwilling to Speak Up About Safety Issues
For decades, risk managers have tried to improve safety by encouraging patients and family members to speak up when they are concerned about care or suspect something might be wrong. Some progress has been made, but recent data suggest one group remains reluctant to speak up: the parents of pediatric patients. -
Star Ratings Use Standardized Weighting of Measures
CMS explains the new 2021 methodology for its Hospital Quality Star Ratings uses “a simple average of measure scores to calculate measure group scores and Z-score standardization to standardize measure group scores” in five measure groups. -
Latest CMS Star Ratings Include Welcome Changes
Hospital leaders had criticized previous ratings because they believed the methodology used to create them was flawed and produced inconsistent results that made the ratings misleading and not useful to consumers. -
Hospital Attains QCDR Status, Improves Quality Metrics
Alteon Health, a physician-owned and physician-led acute care medical group based in Germantown, MD, recently became a Qualified Clinical Data Registry (QCDR), a Centers for Medicare & Medicaid Services-approved vendor that is in the business of improving healthcare quality. QCDRs may include specialty societies, regional health collaboratives, large health systems, or software vendors working in collaboration with one of these medical entities.
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OSHA, CMS Step Up Hospital Inspections
The Occupational Safety and Health Administration has issued a National Emphasis Program to ensure that employees in high-hazard industries, such as healthcare, are protected from contracting SARS-CoV-2.
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The Basic Elements of Healthcare Reimbursement, Part 3
In this month’s issue, the conversation on healthcare reimbursement turns to the additional prospective payment systems found across the continuum of care. Prospective payment remains a way in which the Centers for Medicare & Medicaid Services can determine the rates for care based on predetermined amounts rather than on billing. The processes are similar to the use of the diagnosis-related groups in the acute care setting, with some differences.
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CMS Extends Hospital Survey Limitations
Agency restricts hospital complaint surveys to immediate jeopardy allegations.