Q: I perform monthly HIPAA audits of computer systems at the medical group where I am employed. I recently started auditing physicians and allied health professionals who are credentialed members of our medical staff.
Incentives posed by the Institute for Healthcare Improvement's Triple Aim Initiative and value-based purchasing emphasize treating the whole person to include preventive, medical, dental, postacute, community, mental health, and addiction services.
More and more hospitals are choosing to become part of Accountable Care Organizations (ACO) in an effort to streamline patient care and reduce costs. If your organization is considering joining an ACO, you may have questions about how these groups work and how the change might affect your job. CMM asked several experts for the lowdown on what the transition to an ACO might mean for case managers.
Whether it's a precautionary CT scan that may not really be needed or a duplicate laboratory test ordered by separate physicians, many hospitalized patients are getting unnecessary tests, and experts say it's a big problem.
