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Embracing Telehealth Demands as a Small Practice

By | Blog, healthcare management consulting, MIPS consulting

The COVID-19 pandemic resulted in many healthcare providers unexpectedly needing to turn to virtual treatment solutions. The transition may have been relatively smooth for larger healthcare providers with greater resources, but smaller practices had to deal with even more challenges. It wasn’t until the government instituted regulatory changes to broaden reimbursement for virtual visits that the smaller practices began to believe they, too, could move in that direction. As patients began seeing their local practices offer telehealth, their interest also increased.

The very makeup of a smaller practice forces it to think more creatively in planning and adopting emerging telemedicine needs. Some items to keep in mind include patient needs, where they come from, and what technologies they and the medical staff might use to reap the most benefits. Telehealth does not necessarily have to completely replace in-person visits, but practices could offer after-hours consultations to patients or asynchronous services for patients that require ongoing care.

Smaller practices may also wish to seek out telehealth resource centers. In addition to federally funded programs, private companies such as CareOptimize offer comprehensive telehealth services. Providers should also ensure that whatever telehealth solutions they use are compliant with HIPAA regulations, even if those regulations are being temporarily relaxed.

The future of telehealth post-pandemic remains to be seen, but many of the pieces are now in place to give all size practices the ability to institute and maintain successful telehealth programs.

To read more, please visit https://www.healthcareitnews.com/news/heres-how-smaller-practices-can-prepare-continuing-telehealth-demands.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, Nextgen EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

Telehealth Leads to Better Care and Revenue with Chronically Ill Patients

By | Blog, healthcare management consulting, MIPS consulting, Telehealth

Telehealth offers critically ill patients and their healthcare providers opportunities to raise income and improve quality of treatment. Telehealth appointments frequently represent a more convenient approach versus an in-person visit, and the costs are often markedly less than an emergency room visit. Instead of making an unnecessary trip or incurring a hefty emergency room charge, patients using a telehealth platform are able to virtually talk with a physician or a nurse via computer, phone, or tablet.

For healthcare practices, telehealth appointments with chronically ill patients create several revenue opportunities. Regulations have relaxed, and Medicare offers even more leniency when it comes to reimbursing telehealth services. Physicians can now receive the same amount reimbursed for a telehealth appointment as they would for an in-person visit, leading to a more stable revenue stream. Telehealth and remote monitoring for patients with chronic conditions in value-based contracts also enables physicians to reach quality care targets and reduce unneeded readmissions, leading to greater incentive payments.

Regular communication with chronically ill patients solves multiple problems. It’s challenging to keep a consistent chronic care management program going when patients might be afraid to come into the office. Those who need a physical, follow-up visit, or have regularly scheduled appointments, can now keep up with those via virtual visits. As a bonus, providers can also more easily evaluate the home environment with the virtual visit “show and tell” opportunity.

Telehealth has emerged as a good way to provide revenue opportunities, offer more convenience, and avoid interrupting care management programs. Many providers are seeing the benefits.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, Nextgen EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

Things to Consider as Healthcare Facilities Move to Reopen

By | Blog, healthcare management consulting, MIPS consulting

Healthcare providers, using the directions mandated by federal and local governments, locked down their facilities to avoid the spread of COVID-19. This also meant shutting down main clinical service lines and canceling in-person appointments for patients. However, vendors are beginning to open their doors once again with the pandemic subsidizing in some regions.

According to recent data collected by The New York Times, the number of reported COVID-19 cases is dropping in close to half of states around the country, with several other states showing no statistically important change.

Just as healthcare facilities have decided to refrain from in-person appointments to minimize exposure, providers will also need to evaluate safety measures to reduce patient and provider contact with the coronavirus.

According to CMS guidelines, the optimization of telehealth services should be a major priority for healthcare facilities. Providers should remain focused on providing virtual care where appropriate to reduce the risk of spread of the virus, especially if they are dealing with patients that have severe or chronic conditions.

Should a scenario arise where in-person care is required, healthcare facilities should seek tele-triage services prior to resuming in-person care. Boosting remote patient monitoring and other telehealth capabilities may also assist providers with ensuring care access for patients who need medical care but are staying away from healthcare facilities due to understandable concerns.

To read more, please visit https://revcycleintelligence.com/news/key-considerations-for-reopening-healthcare-facilities-amid-covid-19.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, next-generation EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

The Push for Extended CMS Telehealth Waivers

By | Blog, healthcare management consulting, MIPS consulting

Many providers and patients have not only become accustomed to the rapidly devised telehealth exemptions, but they also believe it’s an optimum approach to delivering basic healthcare services until the coronavirus is no longer a major threat. This positive attitude about telehealth may also serve as a way to ensure those changes, which some advocates of telehealth were big fans of long before COVID-19 surfaced, become the norm.

Earlier in 2020, CMS took considerable steps to relax regulations relating to the use of telehealth services, stating it was the proper response to make sure patients would still receive services while cities across the country were on lockdown to reduce the spread of COVID-19.

Just over two months later, access to remote care providers has exploded. The powerful American College of Physicists (ACP) lobbying group is one of the groups requesting the changes to remain in place on a long term basis.

In addition to easing regulations and compensation for telehealth services, ACP also wants the newly-granted autonomy to remain in effect in the direct supervision of doctors working at teaching hospitals, along with continuing fee increases for hospital divisions offering these services.

To read more, visit https://www.healthcaredive.com/news/calls-mount-for-cms-to-extend-telehealth-waivers/579264/.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, next-generation EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

Deriving Value from Your EHR Data

By | Blog, healthcare management consulting, MIPS consulting

An electronic health record (EHR) is perhaps the costliest investment in technology a hospital or healthcare system makes. Most healthcare agencies are hesitant about investing in new technology after the high expense of an EHR. As a result, they use their EHR analytics functionality to attempt to conduct analytics across the organization. How are they doing with such an approach? A Definitive Healthcare survey suggests there may be room for improvement.

The survey reveals healthcare systems using only EHR analytics components are more challenged by technology, whereas consumers who use in-house or analytics-specific systems are less technologically challenged. Organizations that do not use EHR analytics cite similar challenges in technology.

Analytics within an EHR often have limited functionality for results necessary to discover ways to improve outcomes. Because the developers of analytics-specific platforms are well-versed in data analytics and how to create value from results, those products often elicit better, more useful information, especially when combined with the EHR analytics.

Barriers to the use of analytics-specific platforms fall into three categories: cost, interoperability with existing technology, and leadership buy-in. Studies have shown these platforms create significantly more value by reducing cost, improving patient outcomes, and offering a better overall view. The value of results elicited often outweighs the barriers.

The CareOptimize Nextgen EHR page features several products we’ve developed to assist healthcare organizations with easing the process of navigating the rapid changes in healthcare technology.

To read more, please visit https://www.healthitoutcomes.com/doc/how-to-derive-value-from-the-data-in-your-ehr-0001.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, next-generation EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

The Latest CMS COVID-19 Billing Updates for Hospitals

By | Blog, healthcare management consulting, MIPS consulting

CMS’ latest and revised COVID-19 billing policy seeks to help hospitals and alternative care sites get paid for treatment given during the emergency. Late last month, CMS revised FAQs regarding Medicare fee-for-service billing. The revised FAQs provided more clarity on how CMS enforced an increase in hospital IPPS reimbursement, including the process involved in identifying COVID-19 discharges.

Most of the new questions focused on payments based on the Coronavirus Help, Relief and Economic Protection Act (CARES) for the Hospital Inpatient Prospective Payment Program (IPPS). The CARES Act, passed at the end of March, provides billions of dollars in funding to hospitals and other healthcare facilities, including a provisional 20% rise in IPPS patient reimbursements for hospitalizations related to the pandemic.

According to the FAQs, the amounts hospitals will receive for COVID-19 hospitalizations will vary based on the date of discharge. CMS issued the new payment rates for COVID-19 discharges on and after the 27th of January and on or before the 31st of March, as well as on or after the first of April, over the length of the emergency period.

Along with COVID-19 billing updates for the IPPS, CMS also provided guidelines on how hospitals should bill for services provided at alternative care sites developed to expand capacity during the emergency.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, next-generation EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

Coronavirus Relief Bill Sets Aside $100B for Providers

By | Blog, healthcare management consulting, MIPS consulting

A relief bill aimed at COVID-19 relief would grant providers an additional $100 billion in aid for expenses related to healthcare and lost revenue caused by the coronavirus pandemic.

The Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act, passed by the House on the 15th, is a $3 trillion coronavirus relief bill that seeks to supply further direct payments to an extensive array of coronavirus-affected agencies, businesses and even people. Healthcare organizations and agencies would receive a substantial part of the funding. The legislation also makes improvements to accelerated and variable payment plans under the Medicare terms and an improvement in prospective inpatient prospective payment system outlier compensation under patients that have received a COVID-19 diagnosis. The federal matching rate for Medicaid states is now rising by 14 percent and $75 billion has been set aside to support coronavirus testing and contact tracing.

Ever since the execution of a pair of coronavirus relief packages, the Coronavirus Aid, Relief and Economic Security (CARES) Act and the Paycheck Protection Program and Health Care Enhancement Act, hospitals have been petitioning for more federal government funding. Collectively, the packages provided a Provider Relief Fund of $175 billion.

To read more about the HEROES Act, visit https://revcycleintelligence.com/news/latest-coronavirus-relief-bill-seeks-another-100b-for-providers.

This update is provided by CareOptimize. We provide healthcare management consulting services and products and we’ve helped numerous healthcare organizations succeed for more than a decade. We provide managed care solutions as well as products like coding modules, Nextgen EHR utilities, and more. For more information, please call 855.937.8475.

CMS Seeks to Boost Medicare Reimbursement for Inpatients

By | Blog, healthcare management consulting, MIPS consulting

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) proposed a new rule updating the Inpatient Prospective Payment System (IPPS). Beginning in October, CMS is proposing an update of three percent hospital market basket less a productivity adjustment of 0.4 percentage point. The new Medicare inpatient reimbursement rates will also represent a planned change of 0.5 percentage point mandated by legislation.

Along with these changes, the rule would also allocate nearly $7.8 billion in uncompensated care compensation, down $0.5 billion during the 2021 fiscal year. Furthermore, a new technology add-on payment mechanism will be developed for certain antimicrobial products.

Collectively, the CMS changes being proposed in unpaid care payments, new technology add-on payments and capital payments will reduce inpatient Medicare reimbursement rates by 0.4 percent, resulting in a total rise of approximately 1.6 percent in overall rates under the IPPS. These changes, which would affect more than 3,000 acute care hospitals and close to 300+ long-term care hospitals, would impact discharges occurring on or after October 1, 2020, according to CMS.

If you’re interested, the entire CMS rule proposal can be viewed at the following link: https://www.federalregister.gov/documents/2020/05/29/2020-10122/medicare-programs-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the. For more information about the rule, please visit the source article: https://revcycleintelligence.com/news/cms-proposes-to-increase-inpatient-medicare-reimbursement-by-1.6.

This update is provided by CareOptimize. We provide healthcare management consulting services and products and we’ve helped numerous healthcare organizations succeed for more than a decade. We provide managed care solutions as well as products like coding modules, next-generation EHR utilities, MIPS consulting, and more. For more information, please call 855.937.8475.