Q&A: Clinical integration with provider-based departments

August 21, 2017
Medicare Web

Q. What sort of clinical integration does CMS expect between provider-based departments and hospitals?

A. Hospitals should also be interested in maintaining the quality of their brand across any location that displays the hospital name, including the provider-based departments, both on- and off-

campus. In effect, because of this clinical integration, the hospital is guaranteeing that a patient’s experience is identical in any of the hospital departments, and the transition between the various hospital departments is seamless and easy to negotiate.

CMS expects to find clinical integration in the following six areas:

  • Professional staff
  • Monitoring and oversight
  • Medical staff committees
  • Medical director reporting relationship
  • Unified retrieval system for medical records
  • Outpatients have full access to care at main provider

For more information, see Provider-Based Entities: A Guide to Regulatory and Billing Compliance, Second Edition.

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