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Navigating the Complexities of Social Admissions in Healthcare

EvidenceCare

Social Admission vs. Medical Necessity In healthcare, the term “social admission” signifies instances where patients find themselves admitted to a hospital primarily for non-medical reasons. However, these admissions come with their own set of difficulties, particularly in the realm of Medicare coverage and reimbursement.

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Navigating Medicare Advantage: Strategies for Hospitals to Tackle Growing Challenges

EvidenceCare

Written by Carol Howard, VP of Clinical Strategy As Medicare Advantage (MA) continues to grow, hospitals have faced growing challenges in navigating complex policies, payer friction, and financial pressures. These changes will impact how hospitals approach their contracts and denial strategies.

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New Insights on Medicare Advantage Plans and The Two-Midnight Rule

EvidenceCare

In case you aren’t familiar, the Two-Midnight Rule mandates that a patient’s hospital stay must span at least two midnights to qualify for inpatient status, directly influencing reimbursement rates and compliance requirements. In the MA Final Rule, however, CMS explicitly states that the two-midnight presumption does not apply to MA plans.

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Preparing for CERT Audits and Practicing Compliant Documentation

EvidenceCare

This comprehensive guide provides hospital and revenue cycle leadership with vital insights on preparing for CERT audits and establishing processes for compliant documentation. Hospitals need to be aware of these state-specific rules as well. Think of your documentation as the ironclad defense for your hospital admissions.

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Writing Compelling Activity Descriptions to Boost Your Med School Application

Accepted Blog

Having worked in admissions for over two decades, I have read thousands of activity descriptions for medical school and related healthcare fields. Other applicants fill out only a few of their activity descriptions, leaving the admissions committees to wonder what they did with the rest of their time. A nonprofit organization?

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Nurses Hacking for Health, Addressing Burnout, Workplace Violence, and AI

Health Populi

Three in four nurses working in hospitals care about the success of their institution — “they show up and gown up…yet only 57% feel a sense of ownership in their hospitals, leaving leaders to expect 100% quality to be delivered by about half of the nursing workforce.” health system.

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Choosing a Control Group

Sensible Medicine

Patients may develop a disease that requires admission to the hospital, mostly because of lung problems, such as the need for oxygen. Indirect organ damage is common in medical conditions that are severe enough to warrant admission to the hospital. The disease might affect other organs—either directly or indirectly.