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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.

Hospital 130
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CNOs Share Their Hopes (And Fears) for Virtual Nursing

Scrubs

Trinity Health announced it will introduce virtual nursing at its hospitals in Michigan and Ardent Health Services plans to do the same in New Mexico. It can also reduce the workload at the bedside by having remote nurses do admissions, discharges, and answer questions virtually.

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Understanding DRG Codes and Their Impact on Hospitals

EvidenceCare

In our efforts to empower hospital clinicians to provide better care by having real-time transparency to cost and benchmark utilization data, we’ve learned that one of the core code systems that defines modern hospital resource management – Diagnosis-Related Groups (DRG) – is misunderstood or even unknown. What is a DRG?

Hospital 130
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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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The Median Hospital Charge In the U.S. for COVID-19 Care Ranges From $34-45K

Health Populi

The median charge for hospitalizing a patient with COVID-19 ranged from $34,662 for people 23 to 30, and $45,683 for people between 51 and 60 years of age, according to FAIR Health’s research brief, Key Characteristics of COVID-19 Patients published July 14th, 2020. Even if that patient did not survive her hospital stay.

Hospital 148
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Understanding GMLOS and ALOS

EvidenceCare

These measures play a fundamental role in hospital management, financial planning, and patient care optimization. By understanding and leveraging GMLOS and ALOS, hospital executives can improve operational efficiency and patient outcomes. It is the simplest and most commonly used metric for evaluating patient stays.

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Emergency department admission rates vary widely among physicians, study finds

Medical Economics

Patients hospitalized by physicians with higher admission rates are likelier to be discharged within 24 hours but no less likely to die.