Reimbursement
Humana joins Aetna in covering in-patient hospital admissions for COVID-19 related treatment.
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Revenue Cycle Management
Understanding contract loopholes, and being self-advocates during negotiations, can help community hospitals increase their collections.
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Strategic Planning
In Orlando, health IT professionals will get an update on what FHIR currently can and can’t do – and what to expect from it going forward.
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Capital Finance
Revenue is tanking, while expenses are going up, as organizations prepare for big surges in coronavirus cases.
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Supply Chain
With COVID-19 spreading, Trump has suggested that the increase in demand for supplies may not be due solely to the virus.
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Budgeting
With a labor-intensive budgeting process that provided little business value, OSF Healthcare decided it was time to be more flexible.
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Quality and Safety
Half of U.S. physicians say they have treated a patient with COVID-19 symptoms, while three-quarters report not being able to test easily.
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Billing and Collections
Since all of the estimates are based on pneumonia, it’s likely that costs will be even higher during the coronavirus outbreak.
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Claims Processing
Prior authorization requirements have hindered freeing up hospital beds due to delays in getting inpatients to post-acute care.
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Workforce
The message is clear: Nurses and physicians should treat asymptomatic patients as carefully as symptomatic patients.
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Operations
While not all insurers may be aware of it, prior authorizations can have detrimental downstream financial effects for hospitals and health systems.
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Medical Devices
The custom sensor would measure information from the body beyond heart rate, report says.
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Compliance & Legal
Anthem claims the DOJ has violated the law in holding Medicare Advantage plans to payment standards that are not applied to regular Medicare.
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Policy and Legislation
HHS and CMS should immediately distribute funds to every hospital at the rate of $25,000 per bed, or $30,000 in hot spots, AHA says.
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Community Benefit
The nonprofit health system has sponsored numerous programs and services that help address social determinants of health.
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Accountable Care
Lack of information on key financing aspects is preventing ACOs from signing on, says NAACOS president.
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Acute Care
There was a 2% drop in ICU deaths at non-minority hospitals, but the same improvement rate was not seen at minority-serving hospitals.
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Ambulatory Care
The institutions that were studied added more than $562 billion in value to the nation’s economy in 2017, including direct and indirect economic impact.
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Analytics
At HIMSS20, one physician association will show how data-driven care management, with prompt patient outreach, helped decrease ED use by 8%.
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Business Intelligence
Report analyzed more than 1.8 billion commercial healthcare claims and data visualization to benchmark prices and use across 112 metropolitan areas from 2012 to 2016.
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ICD-10 & Coding
Doctors need to carefully and properly use the HCC codes, which indicate the expected costs for a patient.
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Meaningful Use
Administrator Seema Verma said changes to the program eliminate 25 measures and saves hospitals over 2 million hours of work and $75 million.
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Medicare & Medicaid
CMS is also allowing ERs to use drive-through testing and telehealth, and for tests to be done at home for stay-at-home residents.
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Patient Engagement
More robust SDOH data is not only a care quality consideration, but a business consideration as payers, providers seek a whole-person view.
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Pharmacy
Should states win their case to regulate how PBMs contract with pharmacies, plan costs will rise, AHIP says.
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Population Health
UnitedHealth Group previously announced $50 million to fight COVID-19 by supporting healthcare workers, seniors and hard-hit communities.
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Risk Management
IT security is a legacy word, says Brian Selfridge: “This isn’t cybersecurity, this is risk.”
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Telehealth
Paradise Medical Group is running a virtual practice as the federal government has announced expanded access to telehealth services.
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