Medicare’s Readmissions-Reduction Program — A Positive Alternative

Medicare’s Readmissions-Reduction Program — A Positive Alternative

Tuesday, September 15, 2015

Did you know that hospital “readmissions” is considered a costly event in terms of both financial impact and negative health outcomes for affected patients? While some readmissions are “planned” as part of a care treatment, those that are not “planned” are to be coded on the medical record to enable tracking of the event for future improvement. These “readmissions” are indicated by the use of “Modifier 78” when submitted for claim reimbursement....

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Medicare Fines 2,610 Hospitals In Third Round Of Readmission Penalties

Medicare Fines 2,610 Hospitals In Third Round Of Readmission Penalties

Tuesday, September 15, 2015

Did you know that Medicare is stepping up its efforts to reduce hospital readmissions? Last year, nearly 18 percent of Medicare patients (roughly 2 million patients) who had been hospitalized were readmitted within a month. This costs Medicare (and taxpayers) nearly $26 billion per year, of which $17 billion is considered avoidable. Fines over the next twelve months expect to reach $428 million, including a maximum penalty of 3% of reimbursements....

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Modern Healthcare website checking the percentage penalty that Medicare is assessing each hospital for readmission and other issues

Modern Healthcare website checking the percentage penalty that Medicare is assessing each hospital for readmission and other issues

Tuesday, September 15, 2015

Did you know that Modern Healthcare offers a site to check the percentage penalty that Medicare is assessing each hospital for readmission and other issues? Other ratings sites for medical providers include: Vitals.com, Healthgrades.com, Leapfrog.com, Zocdoc.com and Healthcare.gov....

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U.S. Healthcare Ranked Dead Last Compared To 10 Other Countries

U.S. Healthcare Ranked Dead Last Compared To 10 Other Countries

Tuesday, September 15, 2015

Did you know that the United States ranked "dead last" among 10 developed countries in terms of delivered care by the Commonwealth Fund? Countries were ranked on the basis of quality, access to care, efficiency, equity and healthy lives.It’s fairly well accepted that the U.S. is the most expensive healthcare system in the world, but many continue to falsely assume that we pay more for healthcare because we achieve better health outcomes. The evidence, however, clearly doesn’t support tha...

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Patients Can Do More to Control Chronic Conditions

Patients Can Do More to Control Chronic Conditions

Tuesday, September 15, 2015

Did you know that disease management can help patients with chronic conditions live longer, healthier lives? For the millions of Americans over 50 who have already been diagnosed with chronic ailments like kidney disease, diabetes, heart disease, rheumatoid arthritis and chronic obstructive pulmonary disease, careful management can't turn back the clock, but it can buy time. It takes adherence to medications, sticking to recommended diet and exercise plans, and getting regular checkups. ...

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Overkill

Overkill

Tuesday, September 15, 2015

Did you know that Walmart has launched a program for employees undergoing spine, heart or transplant procedures? Employees would have zero out-of-pocket costs if their treatment was performed at one of 6 "centers of excellence" nationally. Interestingly, per Sally Wellborn, senior vice president for benefits at Walmart, nearly thirty percent of the employees slated for spine surgery are told the treatment they seek is inappropriate....

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Seniors Flock To Star-Rated Medicare Plans Under ACA Rollout

Seniors Flock To Star-Rated Medicare Plans Under ACA Rollout

Tuesday, September 15, 2015

Did you know that more than half of seniors enrolled in Medicare Advantage plans are now enrolled in plans with ratings of four or more stars on a five-star scale, a ranking system created under the health law to guide seniors to cost-effective and higher quality benefits? Plans are rated on such measures like call waiting times as well as how well they encourage preventive care....

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