Articles Tagged With: Medicare
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HRSA Compliance Exposes Hospitals to Liability and Fines
The Health Resources and Services Administration program that reimbursed providers for COVID-19-related treatment for uninsured patients was instrumental in helping hospitals survive the pandemic without excessive financial losses. But the federal government is looking at how that money was obtained and whether it was spent properly.
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FQHC Program Created Innovative Partnership with Other Organizations
Just as it takes a village to raise a child, it takes a village to care for an elder. With this philosophy in mind, a community health center in California has partnered with various local organizations to better serve its growing elderly patient population.
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Care Coordination, Value-Based Care, and Reducing Medicare Spend
Insurers and CMS have encouraged providers and health systems to adopt value-based care to lower healthcare costs and increase competitive positioning. Investing in value-based care means a greater emphasis on the primary care physician and preventing hospital admissions and readmissions. -
Biden Administration Cracking Down on Nursing Home Safety
The Biden administration is promising an effort to improve safety and quality of care in the nation’s nursing homes. The fact sheet foreshadows substantially stiffer oversight and harsher enforcement. -
Integrating Behavioral Health and Medical Case Management
The effects of COVID-19 have brought behavioral health issues to light — and, in some cases, the handling of the pandemic has even caused behavioral health problems. With more patients presenting with mental and behavioral health issues, it is more important than ever to consider a collaborative model of care. -
Best Practices in Utilization Management
Ideally, the case manager’s utilization management role integrates discharge planning, care coordination, and resource management. It takes place on the unit where the case manager can interact directly with the care delivery team. It also is important for departments and hospitals to develop policies for utilization management procedures at the outset. -
How a Transitional Care Leader’s Organization Survived the Pandemic Chaos
In this Q&A, Hospital Case Management asked Vera Usinowicz, APN-C, supervisor of The Center for Comprehensive Heart Failure Care at The Valley Hospital in Ridgewood, NJ, to discuss how her transitional care unit kept heart failure patients out of the emergency department and hospital during the COVID-19 pandemic. -
Loneliness and Social Disconnection Common During COVID-19 Pandemic
More than one-third of Medicare beneficiaries said they were more socially disconnected, and nearly one in four reported they were lonelier during the COVID-19 pandemic, according to the results of a recent survey. -
Limited English Proficiency Can Impede the Transition Process
As the United States becomes more diverse, healthcare facilities treat more patients with limited English proficiency. This highlights the need for more effective interpreter services, especially at discharge. Care coordination and transitions could improve if health systems provide more consistent and adequate interpretation help to patients with limited English proficiency, research shows. -
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.