Remove Admissions Remove Discharges Remove Follow-Up
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STRONG HF – A Positive Trial that Does Not Help Clinical Medicine

Sensible Medicine

The Trial STRONG-HF studied two treatment strategies after a patient was discharged from the hospital after treatment for heart failure. Actual cardiologists performed these visits, which included up-titration of meds, but, also, as Adam correctly notes, patients had MD-level assessments. Here were the results.

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Navigating Medicare Advantage: Strategies for Hospitals to Tackle Growing Challenges

EvidenceCare

CMS Policy Changes to Reduce Costs Financial pressures are rising as CMS implements the updated Version 28 Hierarchical Condition Category (HCC) model , which introduces changes aimed at limiting types of codes that are most used for up-coding or over-coding to help rein in spending. MA plans are looking for contradictions in provider notes.

Hospital 130
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Highs and Lows

Sensible Medicine

Luciana Luciana’s discharge day was getting close. Her outpatient follow-up appointments were scheduled; we had reviewed her safety plan; she felt well and ready to leave the hospital. ” Seizing the interruption before I turned this into a full-blown therapy session, I got up and brought the tray over to her desk.

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Preparing for CERT Audits and Practicing Compliant Documentation

EvidenceCare

From understanding the audit requirements to implementing technology for streamlined admission documentation , this article offers actionable strategies to ensure hospitals are well-prepared for the rigorous evaluation process. Think of your documentation as the ironclad defense for your hospital admissions. As researched by OS Inc.,

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

EvidenceCare

This also means that the medical record must support the reasonableness of the clinician’s admission decision regardless of the total time spent in the facility. We’re still facing the same types of denials, especially with short stays where payers push back post-discharge.” Another issue is “inpatient only” procedures.

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AI is Transforming Healthcare Behind the Scenes

Mobius MD

Having AI check errors gives providers peace of mind while speeding up reimbursements and minimizing costly denials. By predicting admissions and discharge patterns, AI helps prevent overcrowding and reduces wait times. These tools optimize appointment slots to reduce schedule gaps and keep clinics running smoothly.

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How BPCI Enhances Patient Experience and Lowers Costs: A Comprehensive Guide

Guideway Care

Advancing these efforts, the BPCI Advanced model introduces a consolidated retrospective payment system that addresses services within a 90-day period following discharge or outpatient procedures. These particular models concentrate on consolidating payments for all services provided during an episode of care into one bundled payment.