As more hospitals adopt EHRs over paper records, the amount of data stored electronically steadily increases. However, the usefulness of this data diminishes if it does not translate to meaningful information that hospitals can use for operations surrounding registration, treatment, billing, coding, and research.
When you're starting a population health program, a critical component is information?the data you collect to assess patient risk factors. Having a computer system to sort through information and help you identify high-risk patients is a huge asset to any program, says Gavin Malcolm, LCSW, director of Population Health for Broward Health ACO Services in Florida. "You have to be able to access and manage data to be successful," he says.
Starting a population health program can not only help organizations improve patient health, but can also help a hospital's bottom line by reducing readmissions and cutting down on costly emergency department visits. But many case managers may wonder what it takes to get a population health program off the ground.
Phase 2 of OCR's HIPAA audit program is coming down the pipeline, and although privacy and security officers are typically tasked with all things HIPAA, there's a seat at the table for HIM when it comes to preparing for audits.
A few days after Briefings on APCs conducted the interview that appeared in last month's issue with W. Jeff Terry, MD, an AMA delegate from Mobile, Alabama, the AMA and CMS announced an accord regarding ICD-10.
In a joint announcement, the organizations said that CMS would not audit or deny Part B physician fee schedule claims for one year after ICD-10-CM implementation due to lack of specificity. While physicians will still be responsible for meeting medical necessity and LCD and NCD requirements, valid ICD-10-CM codes that include the appropriate first three characters will be sufficiently specific for Medicare claims.
One of the biggest challenges to the provider community, including hospitals and critical access hospitals (CAH), is keeping up to date with current regulatory requirements, particularly when it comes to rules on coverage, coding, billing, and payment for services provided to beneficiaries under federal healthcare programs, including Medicare and Medicaid. For those of you who have taken one of our hospital or CAH Medicare Boot Camps, you probably remember discussing this early during the week, when we identified the major official sources of authority on Medicare rules, as well as some tips about how to efficiently keep yourselves up to date.
