In the first article in this series, we provided an introduction and overview of the PSI 90 measure, which is included in two CMS pay-for-performance programs. Because PSI 90 is a claims-based measure, performance is largely determined by ICD-9-CM codes on the claims.
Finding themselves at the center of a tumultuous, dynamic healthcare environment, physicians are becoming increasingly frustrated and anxious, frequently questioning their career choice. Preparation to be a lifelong healthcare provider inadequately prepares clinicians for the emerging value-based healthcare world to which they are being subjected. Physicians believe that they have little control over or input into the metrics that are rapidly determining their fates with healthcare organizations, third-party payers, and inevitably patients themselves.
Technology is everywhere, including hospitals and doctor's offices. Studies have found that in some cases technology can be an asset to patient management, with remote monitoring showing promise in helping to reduce readmissions.
Your success as a case manager often depends on how well you work with others in your organization. At any organization, ensuring high-quality patient care, accurate documentation, and regulatory compliance takes a team effort.
