News & Analysis

July 1, 2019
News & Insights

Q: Our utilization review (UR) committee originally took a more strictly peer review role but over time its scope and responsibilities have broadened. We're not sure that it still makes sense for the UR committee to be categorized as a subcommittee of the medical staff. What is the current recommended reporting structure for a UR committee?

July 1, 2019
Case Management Monthly

There are some changes to the Beneficiary and Family Centered Care-Quality Improvement Organization’s (BFCC-QIO) program, and if you’re one of the organizations affected by the changes, you may need to update your patient notices to reflect them.

July 1, 2019
Case Management Monthly

Case managers typically provide support to adult patients in the hospital, focusing on their medical and social needs and easing their transition to the next level of care. But often, these patients aren’t the only ones who need support—they sometimes also have children or grandchildren who are struggling.

July 1, 2019
Briefings on APCs

Our experts answer questions about billing for pre-admission testing, categorizing types of denials, and more.

July 1, 2019
Case Management Monthly

CMS recently announced a new category of payment programs: the Primary Cares Initiative. Within a few years, CMS expects 25% of primary care providers to join one of the five voluntary payment models.

July 1, 2019
Case Management Monthly

A hospital case manager tries to get a power wheelchair for her elderly father and runs into roadblocks along the way.

Pages