CMS, the Veterans Health Administration, and some states measure our care quality based on risk-adjusted readmission rates after inpatient admissions. In fact, up to 3% of our hospital’s Medicare inpatient revenue (used to pay physician subsidies) is at risk if we don’t manage our patients’ readmissions in concert with Medicare’s algorithms.
This week’s Medicare updates include two compliance reviews from the Office of Inspector General, an enforcement instruction on supervision requirements for outpatient therapy, clarification of instructions for medical reviews of inpatient rehabilitation facility claims, and more!
CMS’ Chronic Care Management service is aimed at strengthening access to chronic care management services in primary care settings while reducing costs, and a report on the program prepared by Mathematica Policy Research for CMS indicates its doing just that.
Auditing of technical controls is increasingly important as both the level of use and technical sophistication of applications, hardware, and networking increase.
