As more hospitals adopt EHRs over paper records, the amount of data stored electronically steadily increases. However, the usefulness of this data diminishes if it does not translate to meaningful information that hospitals can use for operations surrounding registration, treatment, billing, coding, and research.
When you're starting a population health program, a critical component is information?the data you collect to assess patient risk factors. Having a computer system to sort through information and help you identify high-risk patients is a huge asset to any program, says Gavin Malcolm, LCSW, director of Population Health for Broward Health ACO Services in Florida. "You have to be able to access and manage data to be successful," he says.
Starting a population health program can not only help organizations improve patient health, but can also help a hospital's bottom line by reducing readmissions and cutting down on costly emergency department visits. But many case managers may wonder what it takes to get a population health program off the ground.
The 2-midnight rule may get a little tweak if the proposals in CMS' 2016 OPPS proposed rule comes to fruition. The rule proposes that physicians now be granted a little more flexibility when it comes to ordering inpatient admissions, even when the stay is expected to be less than two midnights?provided of course that the stay is justifiable from a medical standpoint and the physician clearly documents his or her thinking on the case.
1. The audit is intended as an educational tool, but if auditors discover serious noncompliance issues, they may request OCR conduct an investigation to determine if enforcement action is necessary.
The 2016 OPPS proposed rule released July 2 is deceptively short, but packs a punch. CMS is proposing the most massive APC reconfiguration and consolidation of APC groups since the beginning of OPPS, says Jugna Shah, MPH, president and founder of Nimitt Consulting, based in Washington, D.C., and Spicer, Minnesota.
To get a real sense of the financial impact, providers will need to take several steps, says Shah. First, review the narrative text to get a feel for the major categories of changes CMS is proposing, including some of the operational ones.
