It is widely accepted that multidisciplinary rounds are essential for the success of a case management department, especially in ensuring achievement of their metrics. Case management metrics have a broader scope, more so than ever before; the number of metrics, ranging from financial to quality, is growing all the time.
This week's note provides an overview of the eligibility, scope of coverage, effective dates, premiums, and cost-sharing amount policies under the four parts of Medicare. .
This week’s Medicare updates include two new advisory opinions; updates to the Physician Compare, Long-Term Care Hospital Compare, and Inpatient Rehabilitation Facility Compare websites; a republished version of the OPPS final rule to include a previously omitted section, and more!
Most physicians are familiar with the MIPS quality models: These are the Physician Quality Reporting System (PQRS) measures that we’ve been reporting for years with the old Medicare value-based purchasing program. What we don’t know much about are the new cost efficiency models in MIPS, which are based solely on hospital and physician ICD-10-CM/CPT claims data rather than a clinical abstraction of our medical records.
The general rules for security, risk analysis, and risk management implementation specifications, and evaluation standards are key directives for ongoing compliance assurance. Although risk analysis concepts guidance appears in the Security Rule, many organizations use it for auditing Privacy Rule processes as well.
Q: Our facility does not often use open-ended queries to physicians. Could you give an example of an open-ended query and any disadvantages they may have?
