Remove Admissions Remove Discharges Remove Medication
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Navigating Medicare Advantage: Strategies for Hospitals to Tackle Growing Challenges

EvidenceCare

The panel featured Jackie Kimmel , Senior Director of Strategy Catalyst for The Health Management Academy , Dr. Adam Fall , Corporate Medical Director of Utilization Management at Erlanger , and Dr. Jeny McNair , President and Chief Physician Advisor at Physician Advisory Services of Med-Metrix.

Hospital 130
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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.

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All User Bulletin: Admission and Discharge Navigator Optimizations

Connect Care Bytes Blog

Enhancements to Core Admission and Discharge Navigators Connect Care uses "Navigators" to help prescribers complete complex workflows when key tasks are easy to forget. Core "Admission" and "Discharge" navigators organize review (e.g., problem, medication and allergy validation), action (e.g.,

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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. Proper documentation helps demonstrate services were ordered based on medical necessity, not financial gain.

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

EvidenceCare

In other words, the MA plan may focus its medical reviews on stays of any length in order to ensure compliance with the Two-Midnight Rule. 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.

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Understanding GMLOS and ALOS

EvidenceCare

GMLOS is calculated by taking the nth root of the product of the length of stay for a series of discharges, where ‘n’ represents the number of discharges. Unlike GMLOS, ALOS is calculated by adding the total number of stay days for a group of patients and dividing by the number of discharges or admissions.

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Advice for the New Intern 2.0

Sensible Medicine

The slide was meant for new medical student graduates about to start residency. Deliberate practice during internship is probably even more important today than it was in the days before duty hour restrictions and admission caps. Ask yourself what you are doing to solve the problem that led to (or have crept up since) admission.