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Survey Debunks Perception That Medicaid Offers Lesser Levels of Care

May 17, 2017


Healthcare in America is expensive. The share of the U.S. economy devoted to healthcare spending is currently 17.5 percent, and the Centers for Medicare & Medicaid Services (CMS) projects it will reach 19.6 percent by 2024.  Estimates put total U.S. spending on healthcare at more than $5.4 trillion by that point, with both the private and public sectors each contributing approximately 50 percent of costs.  While spending for both sectors may be equal, according to The Commonwealth Fund, Medicaid patients may be receiving better care on some measures than private sector patients.


Attitudes About Aging and End-of-Life Care: Kaiser Survey

May 10, 2017


U.S. Census Bureau projections indicate that Americans 65 and older will make up 24 percent of the U.S. population by 2060.  A majority of adults in the U.S. say that the government is “not too prepared” or “not at all prepared” to deal with the aging population, according to a recent survey conducted by the Kaiser Family Foundation in partnership with The Economist.  This study covered views and experiences related to aging and end-of-life medical care in the U.S., Italy, Japan and Brazil, among a nationally representative sample of adults ages 18 and older.


A Snapshot of Risk Management in 2017: 20 Top Concerns for Hospitals

May 3, 2017


Healthcare’s frenetic pace of change—catalyzed by the Affordable Care Act, and more recently, by efforts to repeal and replace that landmark legislation—have expanded the scope and complexity of regulatory compliance and the importance of comprehensive risk management efforts on the part of hospitals and healthcare systems.  However, the barrage of competing demands in the current environment makes it a challenge for healthcare organizations to know where to focus their time and resources.


The Administrative Burden of EHRs Opens Doors to Medical Scribes

April 26, 2017


A physician's responsibility is to provide the best possible care for sick patients.  A key for delivering quality healthcare is open communication between the physician and patient to discuss issues and develop a care plan.  Today, providing quality care is becoming more difficult due to increasing patient loads and administrative challenges.  This dilemma has become a catalyst for the growth of medical scribes (often referred to as scribes).


CMS Aims to Simplify with Proposed Inpatient Payment Rule

April 19, 2017


On April 14, 2017, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that would update 2018 Medicare inpatient payment and polices.  The proposed rule aims to relieve regulatory burdens for providers; supports the patient-doctor relationship in healthcare; and promotes transparency, flexibility and innovation in the delivery of care.  The proposed rule would apply to about 3,330 acute care hospitals and 420 long-term care hospitals, and would affect discharges occurring on or after October 1, 2017.  The rule will be published in the Federal Register April 28, and comments will be accepted through June 13.


Patient Satisfaction is The Next Competitive Battleground

April 12, 2017


Patient satisfaction and the patient experience have always been important to providers.  In today’s era of value-based care reimbursement models, it has become one of the top three priorities facing healthcare executives, according to a 2013 study conducted by HealthLeaders Media.


The MACRA MIPS Composite Score: A Guide for Providers

April 5, 2017


The Medicare Access & Chip Reauthorization Act of 2015 (MACRA) marked the end of Medicare payment’s fee-for-service model and the beginning of a performance-based payment system, the Quality Payment Program (QPP).  Understanding how participation in the QPP will impact payments begins with understanding the scoring system.


CMS Delays Bundled Payment Programs

March 29, 2017


As noted in our eAlert issued March 16, 2016, bundled payments have long been a part of the healthcare reform debate as a strategy for reducing healthcare costs, but while there has been significant discussion and research relating to alternative payment methods, most healthcare spending is still based on a fee-for-service framework.  Despite recent efforts to measure and provide financial incentives for quality, this system rewards volume, rather than value, for the most part, creating a system where patients and families struggle to navigate across fragmented care silos, and providers must work to maximize utilization to survive.


An Overview of the American Health Care Act

March 22, 2017


The House proposal to “repeal and replace” the Affordable Care Act (ACA), the landmark and controversial legislation that is a signature of President Barack Obama’s administration, indicates that the nation’s healthcare system could be heading for yet another upheaval.  March 21, 2017 marked the seventh anniversary of the ACA.  Although there is still a high degree of uncertainty regarding what the final repeal-and-replace legislation will look like, or when it will appear, any changes to the ACA will have important implications for hospitals, health systems, healthcare professionals and patients.


Growing Medical Debt Requires New Collection Approaches

March 15, 2017


The Affordable Care Act (ACA) and new payment models such as high deductible health plans are contributing to a growth in patient liability.  This emerging trend has put pressure on providers to collect more from patients while better managing their financial relationship.


11 Building Blocks of a Solid Safety Culture

March 8, 2017


The fact that 125,000 fewer patients died due to hospital-acquired conditions in 2010-2015, resulting in a cost savings of more than $28 billion, shows healthcare’s capacity to make strides in improving safety.  But despite encouraging results like these, hospitals and health systems still face a daunting array of hurdles, ranging from the growth of antibiotic resistance to new diseases and outbreaks to sepsis prevention.


ACOs: Who Will Lead the Way?

March 1, 2017


We are in the midst of a period that economists call “creative destruction” of our fragmented fee-for-service healthcare delivery system.  The hope is that it will evolve into a higher-quality, more productive system with strong incentives for efficient, coordinated care.  In any case, the transformation will have profound implications regarding hospitals’ ability to maintain their dominant role in the healthcare system.


Understanding OIG Compliance

February 22, 2017


On October 15, 1976, President Ford signed into law legislation creating an Office of Inspector General (OIG) at the Department of Health, Education and Welfare (HEW).  HEW OIG would become HHS-OIG in 1980 when the Department was redesignated as the Department of Health and Human Services (HHS).


Coalition Targets Root Causes of Health Disparities

February 15, 2017


The notion that healthcare needs are human needs is gaining ground within the healthcare sector.  So is the view of hospitals as important economic anchors that must address these human factors as well as the medical needs of the communities they serve, because the two sets of needs are inextricably linked.


National Health Expenditures and Federal Funding of Medicaid

February 8, 2017


In December 2016, the Office of the Actuary at the Centers for Medicare and Medicaid Services (CMS) issued a study of 2015 National Health Expenditures (NHE).  According to the study, overall health spending grew by 5.8 percent in 2015 to $3.2 trillion or about $10,000 per U.S. citizen, and accounted for 17.8 percent of the Gross Domestic Product (GDP).


Consumers, Employers and Providers Take the Hit from Rising Healthcare Spending

February 1, 2017


Healthcare is changing so fast it will make your head spin.  Keeping up with all the changes is a huge task, even for industry insiders.  Recent news reports demonstrate this:


OIG Report Reveals Two-Midnight Rule Vulnerabilities

January 25, 2017


A study by the Office of Inspector General (OIG) has revealed “vulnerabilities” under the Two-Midnight hospital policy that initially went into effect on October 1, 2013.  In response to the findings, OIG has recommended that the Centers for Medicare and Medicaid Services (CMS) improve oversight of hospital billing under the policy and take steps to increase protections for beneficiaries.  As a result, hospitals are likely to see closer scrutiny to determine whether they are appropriately characterizing inpatient and outpatient stays.


Healthcare Industry Strategic Trends: Takeaways from the JP Morgan Healthcare Conference

January 18, 2017


Last week, MiraMed's senior executives attended the JP Morgan Healthcare Conference in San Francisco along with top executives from more than 450 private and public companies in biotech, pharmaceutical, medical device and technology, as well as healthcare providers, payers, private equity and venture capital firms.  Presentations provided a glimpse of the future in terms of strategic thinking and trends among some of the nation’s largest providers, vendors and investors.


Healthcare’s Newest Security Threat: IoT

January 11, 2017


One of the greatest technological achievements in the 21st Century was is the creation of the Internet.  Its formation has effectively changed almost every aspect of business and personal communication.


Study Shows How to Meet the Needs of Complex High-Need Patients

January 4, 2017


Hospitals and health systems can make a more meaningful dent in the costs of care and improve the value of the care they deliver by zeroing in on the social and behavioral health needs of their most complex high-need patients, according to a new report published by The Commonwealth Fund.


Veterans Affairs Issues Final Rule Expanding Practice Authority

December 28, 2016


On December 14, the Department of Veterans Affairs (VA) published a final rule amending its medical regulations to expand the scope of practice for certain Advanced-Practice Registered Nurses (APRNs) at VA facilities.  The VA believes the rule, which becomes effective January 14, 2017, will make it easier for veterans to be seen by medical professionals by increasing the number of available primary-care providers.


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