By David Squires & David Blumenthal MD – There’s a lot to absorb in the proposed rule for implementing “MACRA”—the sprawling, bipartisan law passed in 2015 aimed at moving Medicare physician payment from rewarding volume to rewarding value. One question attracting scrutiny is whether the reforms will favor larger practices at the expense of smaller ones.
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By Terry Hayes – It’s easy for patients to feel lost in our healthcare system. Between multiple doctors, nurses in and out of exam rooms, tests, re-tests, a handful of prescriptions—not to mention the complex web of how to actually pay for care—patients can feel like they’re caught in a convoluted situation, with rules they don’t understand.
By Amit Gupta MD – Many primary care physicians no longer go to the hospital. Let’s pause for a moment to consider that. It felt like a relatively minor workflow shift as it was happening, but it has major implications for patient care.
By John Smithwick – In the past few years, knowing what happens to patients between visits or after acute episodes hasn’t been a priority for provider organizations. As more and more reimbursements are tied to quality measures and outcomes, organizations are finding it vital to know the health status of their populations so they can spot problems earlier and intervene sooner to prevent the need for costly procedures.
By Terry Hayes – Keeping healthcare information flowing to the right people, at the right time, creates the potential for more effective patient care and population health management. However, a greater number of moving parts also means greater risk.
By Robert Rowley MD – Utilization Management (UM) is ubiquitous in healthcare. It is a system of authorizations for procedures and some referrals, for the determination of medical necessity vs. elective, cosmetic or experimental procedures, for determining bed-day allowances in hospitals, and for establishing preferred drug formularies.
By Mark Grenga – As technology remains at the forefront of prominent healthcare trends, growing mHealth Solutions and global telemedicine markets have reified the predictions of many who previously envisioned the healthcare industry’s tech driven evolution.
By Mike Miranda – The healthcare system is taking full advantage of Business Intelligence tools, such as Data Discovery Software. This newer generation of BI tools is dramatically empowering healthcare facilities around the world to aggressively forge ahead with ultra-enhanced efficiency and performance at macro and micro-levels, alike.
CMS proposed to revise the discharge planning requirements that hospitals, including long-term care hospitals and inpatient rehabilitation facilities, critical access hospitals, and home health agencies, must meet in order to participate in the Medicare and Medicaid programs.