Chronic Care Management (CCM) Services Changes for 2017

For 2016, the single CCM code paid approximately $42. Now there are 3 codes and payment can range from approximately $43 to over $141, depending on how complex a patient’s needs are. A given patient can receive either regular or “non-complex” CCM or complex CCM during a service period if applicable (not both). The difference […]

The diagnosis and management of the adult psychiatric patient in the emergency department.

Clinical policy: critical issues in the diagnosis and management of the adult psychiatric patient in the emergency department. AHRQ discusses (1) In the alert adult patient presenting to the emergency department (ED) with acute psychiatric symptoms, should routine laboratory tests be used to identify contributory medical conditions (nonpsychiatric disorders)? (2) In the adult patient with […]

Senior can save on an average 19% annually on insurance premiums

Seniors enrolled in Medicare Advantage insurance plans could save 19 percent annually on health care spending by switching to a lower-cost Medicare Advantage alternative offered in their area, an AHRQ study found. More than 16 million Americans are covered by Medicare Advantage plans. For each year that enrollees remained in their Medicare Advantage plans, researchers […]

The final rule implements policy and operational improvements to the PERM and MEQC programs

Changes to the Payment Error Rate Measurement (PERM) and Medicaid Eligibility Quality Control Programs (MEQC) (CMS-6068-F) The final rule implements policy and operational improvements to the PERM and MEQC programs that will reduce state burden, improve program integrity, and promote state accountability. Under this final rule, changes to the MEQC program give states flexibility to […]

WE DANCE TILL IT RAINS!

We Dance Till It Rains! I heard the tail end of the Joel Osteen’s broadcast when I turned on the TV this morning. I am guessing his message was about the faith and prayers to suggest that if things do not go as expected (in the short or extended periods of time), then one should […]

Proposed new guidelines and restrictions on some of the most widely used pain medications:

Food and Drug Administration Commissioner Scott Gottlieb has proposed new guidelines and restrictions on some of the most widely used pain medications: Drug makers to conduct doctor education programs on immediate-release opioids Explore whether pain-management training should be required for doctors, as well as nurses, pharmacists or other health-care providers; Survey physicians to ensure the […]

The Placebo Effect

The placebo effect is a powerful, robust and consistent demonstration of the ability of our mindset, in this case, the expectation to heal. What we believe and expect matters. It has strong implications for all the areas of our lives including health care. Change your mindset, change the game | Dr. Alia Crum | TEDxTraverseCity

Has Reduction In Readmissions Rate plateaued?

Readmissions: The rate of reduction in readmissions (dropped from 21.5% to 17.8%) has leveled off in recent years. Does it suggest a plateau in the level of improvements possible under the rule? More than 2,500 hospitals will be subject to a penalty for having too many readmissions. The federal budget will save around $564 million. […]

Transfusing Wisely

A Study Holds Promise to Change Culture of Blood Transfusions in August 2017 Issue of The Joint Commission Journal on Quality and Patient Safety. The overall rate of RBC transfusions without exclusions per 1,000 patient-days decreased from 89.8 to 78.1 percent during the intervention period to 72.8 percent post intervention. A new study in the […]

Readmissions

Half Of Nation’s Hospitals Fail Again To Escape Medicare’s Readmission Penalties as per Kaiser Health News. KHN article shows the average penalty by state and number of hospitals impacted by it. There is a nice article and infographic information that one may want to look at it when it comes to readmissions by Thomas Renshaw. I found […]