Developing standards for healthcare is nothing new — in fact, you could say the concept of identifying quality measures started in the early 17th century, when a Hungarian Doctor, Ignaz Semmelweis, championed handwashing in his clinic.
The latest Home Health Conditions of Participation (CoPs) that went into effect on Jan. 13 have been making waves across our industry. These updated CoPs — standards that agencies must meet in order to participate in Medicare — included several completely new regulations, as well as revisions to many others. And despite the fact that CMS (Centers for Medicare & Medicaid Services) delayed the phase-in date of the new standards, many agencies had to scramble to prepare in time.
On Halloween, as I was waiting for MACRA's Quality Payment Program (QPP) Year 2 ruling to be finalized, I was pondering tricks and treats. Would practices find a full sized candy bar when the door opened or a toothbrush? As trick-or-treaters often find, the ruling was a little of both. For me, the trick is a ruling that came in at a hefty 1,653 pages: the treat, the 20+ page fact sheet and executive summary.
There is so much change in current regulations that it’s easy to see how the home care industry’s strategic direction gets lost to the “tyranny of the urgent.” The new Home Health Conditions of Participation will place increased emphasis on Quality Improvement, yet agencies’ long-term success are not just dependent on their ability to improve quality. What will win in the end are care delivery systems that provide better outcomes for less money.
If there’s one message that healthcare providers, executives, and IT staff have learned through the evolution of Meaningful Use, it’s that the data we collect and report has significant impact on our sustainability.
Not only do the numbers we transmit to CMS matter, but the numbers they send back — in the form of financial reimbursements — also matter.
For most people, summertime means backyard barbecues, ball games, and vacations. But for those of us in health IT, it also means reviewing the proposed 2018 Quality Payment Program Year 2 changes under MACRA. The proposed ruling was released on June 20th, and coming in at 1,058 pages it makes for a seriously long beach read.
Everyone in healthcare knows the importance of getting paid for services, and outpatient diagnostic imaging procedures are no exception. Beginning January 1, 2019, providers must comply with imaging appropriate use criteria (IAUC) — as outlined by the Centers for Medicare and Medicaid Services (CMS) in accordance with the Protecting Access to Medicare Act (PAMA) of 2014 — when ordering Medicare Part B outpatient advanced diagnostic imaging services, such as CT, MRI, and nuclear medicine including PET scans.
Over the past several years, healthcare organizations have been tasked with taking on more and more regulatory standards. The Medicare Access and CHIP Reauthorization Act (MACRA) is just one of the many regulations that the industry is still trying to adjust to. A recent survey found that 64 percent of respondents from provider organizations reported being either unprepared or very unprepared for managing and executing MACRA initiatives. So what exactly is MACRA?
For agencies, there are few situations more stressful than auditor visits. There's never a lot of time to prepare and you always worry about your staff selecting the right clinical and financial reports for surveyors. But you can minimize your stress by getting materials for audits ready in advance, as part of your everyday processes. The more prepared you are, the easier it will be on the day the surveyor arrives at your doorstep.
As Medical Director of Clinical Document Improvement at St. Joseph Health, it is my department’s responsibility to facilitate an accurate representation of a patient’s clinical status, which can be translated into useable, coded data. This data is then processed into quality reporting, physician report cards, public health data, disease tracking, and ultimately reimbursement. As a multi-specialty 380-bed hospital in Orange, CA, with one of the busiest Emergency Departments west of the Mississippi, getting our physicians to document has been an important responsibility.