News & Analysis

April 1, 2016
Case Management Monthly

All readmissions are not created equal.

Research shows that ethnic and racial minorities may wind up back in the hospital after discharge more often than their white counterparts for certain conditions, such as pneumonia and heart failure. This increased rate of readmissions is due to many factors, including:

  • A higher incidence of some chronic diseases
  • Social, economic, cultural, and linguistic barriers to care

 

CMS is hoping to change that with a new publication, "Guide to Preventing Readmissions Among Racially and Ethnically Diverse Beneficiaries." Its authors said that the guide aims to accomplish three main goals:

  1. Providing an overview of the issues that can lead to higher readmission rates among this group
  2. Outlining actions hospital leaders can take to reduce these avoidable readmissions
  3. Providing case studies and examples of initiatives that have worked to reduce readmissions among racial and ethnically diverse Medicare beneficiaries
April 1, 2016
Briefings on HIPAA

Tips from this month's issue


April 1, 2016
Briefings on HIPAA

OCR and HIPAA audits. Give you chills, don't they? Most covered entities (CE) naturally fear getting the letter from the HIPAA privacy and security enforcers saying that they're coming?or that they want something. "Something" usually means your policies and procedures, risk analysis, and mitigation efforts if you've suffered a breach. Bottom line: CEs want to avoid OCR unless they need to go to the agency for information on the HIPAA Privacy, Security, or Breach Notification rules

April 1, 2016
HIM Briefings

In February 2016, just four months after ICD-10 go-live, HIM Briefings asked a range of healthcare professionals to weigh in on their productivity in ICD-9 versus ICD-10.

In general, the time spent coding records has increased since ICD-10 implementation for most record types. In fact, one respondent said his or her facility noticed a 40%?50% decline in productivity. However, another respondent noted that coder productivity often varies based on the physician who documented in the record, as some physicians are more in tune with the language of ICD-10 than others. One-third (33%) of respondents were coders, whereas 21% identified as coding directors, managers, or supervisors. Approximately 16% identified as HIM directors, managers, or assistant directors or managers, while 12% of respondents were clinical documentation improvement (CDI) specialists. A small percentage of quality/performance improvement directors, vendors, consultants, IT directors/managers, billers, and auditors weighed in as well. More than half (53%) of respondents work in acute care hospitals.

One respondent said that his or her facility expects the same productivity in ICD-10 as it had in ICD-9, a nearly impossible feat in some cases. "The productivity requirements have not changed from ICD-9 to ICD-10. The current requirement for our facility is 18 charts per day (minimum 14). Very challenging and almost unobtainable."

The HCPro survey questions asked for the average minutes to code a record type. Some respondents wrote in the daily number of records coded, while others indicated the number of records averaged per hour.

April 1, 2016
Briefings on HIPAA

Subpoenas are a sometimes-unwelcome fact of life for privacy officers. They can be complicated, requesting broad amounts of information that is time-consuming to gather. They can be written in dense legal language that takes time and finesse to decipher. If a subpoena requests PHI, it can also raise privacy concerns and questions about how to honor the subpoena while releasing only the necessary information. Some subpoenas may request information that an organization considers sensitive for other reasons. It can be all too easy to put off dealing with a subpoena until the last minute, then rushing to react without taking the time to really read and understand what it says.

April 1, 2016
HIM Briefings

Last year, as ICD-10 implementation approached, organizations throughout the U.S. reported varying levels of comfort with regard to readiness and understanding of the impact of ICD-10 on physician workflow. For some, it was business as usual. For other physicians, ICD-10 became one more check box on the list of reasons to leave practice.

Pages