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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.

CareOptimize Insights Webinar Is All Telemedicine

By | Blog, healthcare management consulting, Nextgen EHR

Telemedicine has been experiencing immense growth as a result of the COVID-19 pandemic. Practices as well as patients have more information available to them than ever as telemedicine moves to the forefront of healthcare. The next CareOptimize Insights webinar is all about helping you making sense of this new frontier.

This upcoming webinar exclusively discusses telemedicine, including relevant topics such as how it can assist your practice, the challenges it presents, the relaxation of regulatory matters, and where it is headed.

In regard to COVID-19, remember CareOptimize currently provides a pair of free tools to assist with simplifying the monitoring and reporting of coronavirus cases. The template allows you to log in data on patients who test positive or are exhibiting symptoms, then streamline notifications on those patients to the CDC, state health agency, and/or local health department. The report shows all high-risk patients in your organization who should be considered for additional screening or other preventative measures. Bookmark our Insights page or our YouTube channel to view all of our webinars.

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.

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.

COVID-19 Insights Webinar – Regulatory Expansion Continues

By | Blog, COVID-19, healthcare management consulting

We recently uploaded episode six of the COVID-19 Insights Webinar. Topics featured in this webinar include the second round of CMS regulatory changes (including COVID-19 testing and home health changes), Medicaid provider grants, the rapid and continued expansion of telehealth programs, elective surgeries, and more.

We also spotlighted a few of the CareOptimize solutions launched in response to the pandemic, such as our FREE CareOptimize COVID-19 Template designed to allow logging of patient data for those who test positive or show symptoms. Our Crystal Report is also free and is useful for showing all patients within your organization deemed to be high-risk and who may need additional screening.

Episode six and the previous five episodes of our webinar series can be viewed on our YouTube channel: https://www.youtube.com/careoptimize. You’ll also find them on the Insights page of our website along with useful news regarding CMS updates and more: https://careoptimize.com/insights/.

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.

CareOptimize COVID-19 Insights Webinar Returns This Week

By | Blog, COVID-19, Webinar

CareOptimize continues to closely monitor the pandemic and its far-reaching implications on our industry. The challenges continue, and we want to keep you apprised of important trends in the COVID19 response, along with measures we have taken to help.

The COVID-19 Insights Webinar returns this week, where we’ll be covering widespread changes by CMS, how states continue to open for elective surgeries, existing loans and grants, and current telehealth opportunities. This week’s episode will be available on our YouTube channel at https://www.youtube.com/careoptimize as well as the Insights page of our website: https://careoptimize.com/insights/.

This update is provided by CareOptimize. We provide healthcare management consulting services and products and have 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.

CMS Unveils Greater Medicare Payment Flexibility

By | Blog, healthcare management consulting, Telehealth

As a way to improve the healthcare system’s COVID-19 response, Centers for Medicare & Medicaid (CMS) has revealed more Medicare payment flexibilities to deliver telehealth, value-based care, and care beyond the traditional hospital during the pandemic.

Hospitals will earn secure, consistent Medicare payments by upping the number of beds for COVID-19 patients. This latest rule guarantees that facilities such as teaching hospitals, outpatient recovery centers, and community health service healthcare programs will not have to deal with decreased Medicare subsidies to raise the number of beds or patient admissions to minimize the pressure on the acute care system.

In turn, more companies will have the ability to supply and charge telehealth facilities, according to the rule. To broaden telehealth during the pandemic, CMS is forgoing limits on the kinds of providers that will deliver telehealth and is permitting hospitals to charge for remote care provided to hospital outpatients.

Long-awaited improvements to the Medicare Joint Savings Plan (MSSP) were among the flexibilities also announced. Furthermore, CMS revealed that the financial framework will be changed in assessing spending for accountable care organizations (ACOs). ACOs who accept increased financial risk under system rules in their next agreement cycle will also have the option of keeping the current financial risk standard for another year.

To read more, visit https://revcycleintelligence.com/news/cms-reveals-more-flexibility-with-medicare-payment-mssp-changes.

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 Ceases Advance Payments

By | Blog, COVID-19

Centers for Medicare & Medicaid (CMS) recently announced it will be suspending the Advance Payment System for doctors, practitioners that are not physicians, and other qualified suppliers of Medicare Part B. The federal agency is taking another look at the reimbursement rates charged by its Accelerated Payment Plan, a related advance payment system that funds Medicare fee-for-service providers when the filing and/or processing of claims is interrupted.

The CMS decision follows closely in the footsteps of President Donald Trump’s signing of the Paycheck Protection Program and Health Care Enhancement Act, which provides healthcare facilities more than $70 billion to cover revenue losses and other healthcare-related costs as a result of the pandemic.

The Accelerated and Advance Payment Programs have given nearly $60 billion in payments to more than 20,000 Part A providers since the COVID-19 pandemic began, hospitals included. CMS accepted close to 24,000 applications for Part B vendors, including doctors, non-physician clinicians, and medical supply providers.

Payments received by the services are not grants, however. According to revised program regulations in response to the health crisis, providers and suppliers are required to pay back the accelerated and advance payments within one year or less, based on the type of supplier or provider.

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.

CareOptimize COVID-19 Insights Webinar Episode Five Is Ready

By | Blog, COVID-19, Webinar

Episode five of the CareOptimize COVID-19 Insights webinar is here, jam-packed with information aimed at helping you navigate the ever-changing healthcare industry in the age of coronavirus. This week, we focus on what’s going on with the FCC Telehealth Program, other loans and grants, the reinstatement of elective procedures and which states are allowing them, and MIPS credit being given for COVID-19 clinical trial reporting.

Along with our free COVID-19 monitoring and reporting technology, we also cover the rise of Remote Patient Monitoring and how CareOptimize can help. All of this and more is ready for viewing at the following link: https://www.youtube.com/watch?v=BrQHAhfcPV4. You can also watch the webinar by visiting the Insights page of our website: https://careoptimize.com/insights/. If you need to catch up, our YouTube channel has all previous episodes available: https://www.youtube.com/careoptimize.

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