Transition to Value-Based Care

Transition to Value-Based Care

As hospitals, health systems, academic medical centers and hospital-employed physician groups/foundations position their transition to value-based care as a top priority, a goal of improving the patient experience is closely related.   

Physicians should understand the challenges hospitals and physicians now face in the new world of changing reimbursements and how an integrated patient access strategy can lead to both improved clinical and financial performance.  Provider organizations should be  using a centralized approach to improve compliance among their physician practices, prevent revenue leakage, increase physician referrals, and improve the overall efficiency of their staff will also be required.     

Understanding the new trend providers should be able to :

 

•             Identify how industry trends are reshaping how hospitals, health systems and physician groups must interact with and engage their patients

•             Understand how hospital readmissions, poor transitions of care, inconsistent chronic care management, scheduling capacity management, and repeat visits by patients to the emergency department affect operational costs, decrease reimbursement, and often lead to a poor patient experience

•             Detail the benefits and metrics of success of having targeted patient-centered functions managed by centralized call centers and how people, processes, and tools are fundamental

•             Describe how an innovative "concierge" approach to patient interactions helps providers improve financial and clinical performance and allow for a more predictable, repeatable patient experience

AccuChecker is meeting the goals to transition to value-based care and compliance. We have been helping physicians since 1983 with a proven track record. The challenges today are great and providers do not have time to prepare, it is sink or swim.  The current trend :

·         ICD-10 implemented 10/01/2015  ( ICD-11 Forthcoming )

·         PQRS – penalties to be increased and enforced

·         HEDIS

·         Meaningful Use ( Stage 3 to begin )

·         Value-Based Care ( Chronic Care Management (CCM), Transitional Care Management (TCM), Patient-centered medical home recognition (PCMH) )

HPP AccuChecker is the solution to guide you in today’s healthcare – Success and Compliance.

FOR MORE INFORMATION

HPP Management Group, Corp.

5201 Blue Lagoon, Suite 800

Miami, FL 33126

Phone: (305) 227-2383 or 1-877-938-9311

Email: pesilverio@hppcorp.com

Website: http://www.accuchecker.com

OIG Work Plan 2016: Top Things to Watch

OIG Work Plan 2016: Top Things to Watch 

 OIG’s Strategic Plan outlines the vision and priorities that guide OIG in carrying out its mission to protect the integrity of HHS programs and operations and the health and welfare of the people they serve. The Strategic Plan articulates four goals that drive OIG’s work:  

• fight fraud, waste, and abuse;

• promote quality, safety, and value;

• secure the future; and

• advance excellence and innovation.

OIG ensures an efficient and effective use of its resources through integrated planning, monitoring, and reporting processes. Together these processes are used to set organizational priorities that best further our strategic goals, measure and analyze the impact of our work, and inform strategic and operational change.

 

Clinical laboratory payments:

In 2016, the OIG plans to conduct an annual analysis of Medicare clinical diagnostic laboratory tests to examine expenditures and the new payment system.

Using EHR to support care coordination through ACO:

In 2016, the OIG will review the extent that providers participating in ACOs in the Medicare Shared Savings Program use electronic health records to exchange health information to achieve their care coordination goals.

Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) requirements:

The OIG will review the compliance of the IRF PPS in 2016, which covers the documentation required in support of the claims paid by Medicare.

Intensity-modulated radiation therapy (IMRT) Services:

In past OIG review have identified hospitals that have incorrectly billed for IMRT services. Hospitals need to be aware that the OIG intends to review Medicare outpatient payments for IMRT beginning in 2016.

Effects of the Competitive Bidding Program on Medicare Beneficiaries Access to durable medical equipment:

The OIG have plans of determining the effects of the competitive bidding program on Medicare beneficiaries’ access to certain types of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS)—in 2016.

 

FOR MORE INFORMATION

HPP Management Group, Corp.

5201 Blue Lagoon, Suite 800

Miami, FL 33126

Phone: (305) 227-2383 or 1-877-938-9311

Email: pesilverio@hppcorp.com

Website: http://www.accuchecker.com