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

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
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

If you’re feeling drained and uninspired at work lately, you’re not alone. A survey published in the June 4 issue of Annals of Internal Medicine found that burnout among doctors costs the U.S. healthcare system some $4.6 billion each year due to turnover and reduced clinical hours.

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.

July 1, 2019
Briefings on APCs

Before starting an ambulatory or outpatient CDI program, those tasked with the project must first create some universal definitions so everyone is on the same page and speaking the same language.

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