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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. “Many of our health systems that have at-risk contracts are expecting headwinds in revenue of up to 20%.”
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.
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 hospitaladmissions.
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.
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. Post-visit, AI can guide patients through recovery by sending reminders to take medications or schedule follow-ups.
Mercer County Joint Township Community Hospital in Coldwater, Ohio, has suffered a significant data breach involving the electronic protected health information of up to 88,541 individuals. Notification letters were mailed to the affected individuals on February 21, 2025.
NHS England states that regional teams should be working with local government partners to set priorities for 2025/26, with an emphasis on improving timely access to general practice, urgent and emergency care, and reducing long and costly admissions to hospitals or care homes.
And from an admissions perspective, it’s essential that applicants from these groups consider how to best present themselves in their medical school applications. Self-identifying is the easiest way to let admissions committees know that you are part of an underrepresented ethnic or racial group, but it’s not the only way.
Piraino also discusses the role of secondary essays in evaluating applicants and explores why teamwork, resilience, and cultural awareness are important in the admissions process. Show Notes: Our guest today is Dr. Beth Perino, Associate Dean for admissions at the University of Pittsburgh School of Medicine. Well, thank you.
Show Summary Welcome to the 600th episode of Admissions Straight Talk ! Show Notes Welcome to the 600th episode of Admissions Straight Talk. Accepted’s free guide, Med School Admissions, What You Need to Know to Get Accepted can tell you exactly what you need to do. Dr. Schmude, welcome back to Admission Straight Talk.
Prisca Benson, MSN, RN is a a nurse navigator for the neuroscience department at The Valley Hospital. It was not long before I started picking up per diem job opportunities to explore and broaden my horizons as a nurse. In 2014, I got a job as a neurology nurse at my dream hospital, NYP-Columbia University Hospital.
Show Summary Dr. Linton Yee, Associate Dean for Admissions at Duke University School of Medicine joins us to discuss how applicants can earn a spot in this highly competitive program. Show Notes Welcome to the 593rd episode of Admissions Straight Talk. Accepted’s Med School Admissions quiz can give you a quick reality check.
Improving Access and Outcomes Using Success, Effort, Emotion, and Trust Metrics A nurse enters a hospital room for a routine blood draw. Hospitals with higher patient experience scores report a 161% better net margin than competitors with low scores. [1] She greets the patient, explains why she is there, and begins the task.
Health information technology professionals charged with selecting, implementing, updating, and paying for health IT in hospital and care delivery settings are essentially the first-line consumers of health IT specifically, electronic health records. Second, consider user experience.
The mainstreaming of SDoH speaks to the awareness that health is made where we live, work, play, pray, learn and shop… beyond the health”care” system of hospitals, doctors’ offices, and prescription drug dispensaries. McKinsey conducted the survey among over 12,500 U.S.
Pharmacy technician employers can be grouped into four main categories: community pharmacies (retail pharmacies), specialty pharmacies, mail-order pharmacies and hospital pharmacies. However, the day-to-day tasks of a pharmacy technician in a hospital are unique to that environment. Order and maintain protocol specific to inventory.
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. Collaborating with community-based resources allows hospitals participating in the BPCI to more adeptly aid those who are most at risk.
For example, maybe one of your siblings has a rare disability, or you grew up in a town with fewer than 500 inhabitants. Admissions officers believe that diversity in the classroom improves the educational experience of all the students involved. For example, perhaps you’re part of the 0.2% Deeds What have you done?
The most reliable source of information about allopathic medical schools is the Medical School Admission Requirements ( MSAR ) website, offered by the AAMC (Association of American Medical Colleges). Follow these steps: Step #1: Calculate your stats and be kind to yourself. Step #2: Address a decreasing trend in your GPA. We can help!
For this section of our Med School Admissions: What You Need to Know To Get Accepted series, I’ll provide a brief rundown of what happens after you graduate from medical school. The rest is up to you. The drawback of this is having to pick up and move two times. Let’s take a look at the different stops you’ll make along the way.
Some solutions are cropping up to pave the way. But one-size-fits-all solutions centered on medication as a silver bullet to obesity are only setting up patients and payers for failure. Similarly, those whose sole promise is to deprescribe, don’t follow the evidence. They’re itching for an easy off-ramp.
This ensures that their skills remain up to date with growing knowledge and evolving practices. OB/GYN medical assistants can be found in physician offices, family planning centers, hospital outpatient clinics, urgent care, health maintenance organizations (HMOs), and more. Where Do OB/GYN Medical Assistants Work?
In this study, Drane and Shah analyze the input of 386 health care executives, physicians, and clinical leaders working across provider organizations (hospitals, clinics, health systems, physician groups), assessing their perceptions of caregivers’ role with the patients they love and interactions with the health system.
Spending on mental health apps, in particular, spiked up in the COVID-19 pandemic reaching at least $500 million according to Deloitte’s analysis. Avoiding recommended follow-up care such as diagnostic tests and labs, or visits to specialists. Value will be in the eye of that beholder.
As a graduate of medical school in Europe, but having grown up in the United States, I have a little knowledge about both: let’s start with Europe first, which I know a lot of my American readers are rather unfamiliar with. This surprised a lot of my American followers. Wow, right? is a lot less than in the States.
OCR stepped up enforcement of compliance with the HIPAA Rules in 2016, more than doubling the number of financial penalties imposed. The following three years saw similar numbers of financial penalties; however, there was another major increase in HIPAA fines in 2020 when 19 HIPAA violation cases were settled with OCR.
That means making sure they are compliant with all required training, are up to date on evidence-based practices, and have the knowledge and skills to consistently provide high-quality care. Another goal is setting your patients up for success after home health services end.
In hospitals, nursing homes, clinics, and other healthcare settings, Licensed Practical Nurses (LPNs) offer basic care and assistance to patients. The Practical Nurse follows infection control policies and procedures to decrease the risk of contracting a contagious disease. how to move limbs), sensory functions (e.g., hormones). #2
In hospitals, nursing homes, clinics, and other healthcare settings, Licensed Practical Nurses (LPN’s) offer basic care and assistance to patients. The Practical Nurse follows infection control policies and procedures to decrease the risk of contracting a contagious disease. how to move limbs), sensory functions (e.g., hormones). #2
For God’s sake , get UP !” I had collapsed into a heap on the cold, hospital floor, falling unconscious and suffering a seizure. The nurse thrust me up, yanking me off the floor; I was hanging just by the whim of my hollow, spindly armpits. I tried to make out the quivering outline of another hospital bed opposite me.
Show Summary Would you like to hear insight based on decades of experience, both advising applicants to a variety of healthcare programs and working in admissions offices for, again, many different healthcare programs? He discusses the admissions process for healthcare programs. Chuck, welcome to Admissions Straight Talk. [2:29]
We rely heavily on our coding quality team to onboard new coders and get them up to speed on our quality standards,” said Jake Hess, Senior Director of Revenue Cycle Shared Services at Spectrum Health. You’ll need ongoing training for your staff to improve your clinical documentation and avoid the following coding disasters.
We rely heavily on our coding quality team to onboard new coders and get them up to speed on our quality standards,” said Jake Hess, Senior Director of Revenue Cycle Shared Services at Spectrum Health. You’ll need ongoing training for your staff to improve your clinical documentation and avoid the following coding disasters.
Show Summary In this episode of Admissions Straight Talk, host Linda Abraham interviews Dr. Jeffrey SooHoo, Assistant Dean for Admissions at the University of Colorado School of Medicine. SooHoo emphasizes the competitive nature of medical school admissions and the holistic review process used to evaluate applicants.
The report is available for the following facilities: Skilled nursing facilities. Long‐term acute care hospitals. Partial hospitalization programs. Short-term acute care hospitals. Critical access hospitals. Admission source. Home health agencies. Inpatient psychiatric facilities. Average case mix.
Practices will get support for periods of up to six months. It plans to deploy “experienced and skilled” facilitators to practices and set up group-based learning sessions to ensure experience sharing across practices. It followed the pausing of the GP Sustainability Loan Scheme.
However, large technology investments aren’t always realistic in the near term when hospitals and health systems are struggling financially. From the least complex workflows to the highest complexity workflows, finding a minute here or there can add up quickly,” said Hermosillo. Yet the job increasingly requires more expertise.
However, large technology investments aren’t always realistic in the near term when hospitals and health systems are struggling financially. From the least complex workflows to the highest complexity workflows, finding a minute here or there can add up quickly,” said Hermosillo. Yet the job increasingly requires more expertise.
Prism Career Institute, with campuses in Philadelphia, PA, and Cherry Hill and Egg Harbor Township in NJ, offers a practical nursing program for students who want to further their careers or switch up their job opportunities. They must also complete an interview process with a Prism Career Institute Admissions Representative.
Institutional, or hospital pharmacy, involves less public interaction. Working in a hospital pharmacy may involve going on rounds with the doctor or medical students if the particular hospital does rounds, according to Jesie Davenport , CPhT, pharm tech academic lead, and instructor.
Michael Ellison, Associate Dean for Admissions at Chicago Medical School at the Rosalind Franklin University. Dr. Ellison shares his insights on what makes Chicago Medical School unique, how to impress its admissions committee, and what all this information means for you as an applicant. Download your complimentary copy today!
The relationship between patient satisfaction scores, reimbursement, and health outcomes The Centers for Medicare and Medicaid Services’ (CMS) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scoring helps hospitals and governing bodies evaluate patient satisfaction through quantitative measurements.
These results will aid the physician at your hospital, clinic, orthopedic office, sports medicine complex, or private practice, in obtaining a proper diagnosis. While other x-ray techs are familiar with how to work with patients and position properly, you’re still learning how to catch-up.
But, we will never experience those great life lessons, if we never show up to stuff. I had dawdled, in somewhat a deep, drifting thought, up to the muddy cornfields behind the house, crops not yet budded, streaks of morning grey and damp brown for miles up ahead. Only I could roll the blinds up if I wanted to see the sunlight.
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