Medicare Advantage Insurers Hold Sway Over More Hospital Admissions
Forbes Healthcare
JULY 24, 2024
Medicare Advantage is accounting for “a rising share of inpatient hospital days,” according to a new KFF study shows.
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Navigating the Complexities of Social Admissions in Healthcare
EvidenceCare
JANUARY 12, 2024
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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The Median Hospital Charge In the U.S. for COVID-19 Care Ranges From $34-45K
Health Populi
JULY 16, 2020
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. privately-insured people.
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Outpatient is the New Inpatient – The Future of Hospitals in America
Health Populi
FEBRUARY 26, 2020
hospitals and why I’ve titled this post, “outpatient is the new inpatient,” a future paradigm for U.S. This realization is informed by data in a new report from Deloitte, Where have the many hospital inpatient gone? Our ability to create that network outside the hospital is huge.”
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How Routine Medical Care Fuels America’s Opioid Crisis
The Healthcare Blog
MARCH 17, 2025
How Physicians and Hospitals Sustain the Opioid Epidemic For decades, the pharmaceutical industry has shaped medical education, ingraining the belief that opioids are the best first-line treatment for acute pain. Hospitals and health systems have also played a significant role in perpetuating opioid dependence.
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U.S. Hospitals Will Lose $323 Billion in 2020 – Before Accounting for Growing COVID Cases
Health Populi
JULY 1, 2020
health systems are projected to lose $323 billion in 2020 due to declining inpatient and outpatient volumes caused by the COVID-19 pandemic’s impact on the “normal” hospital business. Hospitals racked up over $200 bn in losses between March and June 2020. leading to growing un- and under-insured people).
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Preparing for CERT Audits and Practicing Compliant Documentation
EvidenceCare
APRIL 16, 2024
This comprehensive guide provides hospital and revenue cycle leadership with vital insights on preparing for CERT audits and establishing processes for compliant documentation. Traditional Medicare vs. Medicare Advantage vs commercial insurance). Hospitals need to be aware of these state-specific rules as well.
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The New Financial Toxicity in Health Care: The Cost of Hospitalization
Health Populi
MARCH 22, 2018
Beyond strong medicines, a new financial toxicity has emerged for patients due to hospital inpatient admissions. The “measurement” named in the title is graphed here as the proportion of people who filed for bankruptcy relative to years before or after hospitalization.
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When Bias Turns Deadly: How Medical Bias Killed My 5-Year-Old Daughter
Scrubs
FEBRUARY 22, 2023
As a result of these experiences, I launched my organization Project Diversify Medicine, a digital community on Instagram with over 60,000 followers, with a mission to provide culturally inclusive pre-med educational resources to increase the admission of minorities to medical school. I am a doctor in the U.S.
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Mercer County Joint Township Community Hospital Cyberattack Affects Up to 88,500 Individuals
The HIPAA Journal
APRIL 4, 2025
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. The post Mercer County Joint Township Community Hospital Cyberattack Affects Up to 88,500 Individuals appeared first on The HIPAA Journal.
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Why Is Mobile Phlebotomy a Booming Business?
Prism Career Institute
JANUARY 9, 2025
Mobile phlebotomists visit a variety of hospitals, rehabilitation centers, assisted living facilities, and even private homes to meet with patients. Healthcare becomes more accessible for patients who cannot cover the costs without insurance. Mobile phlebotomy makes it easier for patients to secure financial assistance.
4 Ways to Accessorize While on Duty
Scrubs
OCTOBER 20, 2023
Another study revealed that nurses wearing unconventional attire, such as colorful scrubs reduced anxiety among children in a hospital setting. In fast-paced, high-stress environments like hospitals, it’s vital that other healthcare professionals and patients are able to easily identify who’s who.
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Can the U.S. Improve Health System Performance with Digital Health Tools? Pondering A Big Question for #HIMSS21
Health Populi
AUGUST 6, 2021
More granularly, prevention encompasses screening, counseling, and rates of avoidable hospital admissions for diabetes, asthma, and congestive heart failure. were still uninsured and 40 mm with under-insured situations, as well as millions of insured Americans facing greater unaffordable out-of-pocket costs). For the U.S.,
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Scaling the Social Determinants of Health – McKinsey and Kaiser’s Bold Move
Health Populi
MAY 14, 2019
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.
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Jury Finds Pulmonologist Liable for Failing to Monitor Patient
Pulmonology Advisor - Practice Management
JULY 12, 2024
Case Facts Dr P was a pulmonologist who had a practice and was affiliated with a large hospital. Mr C’s primary care physician had Mr C admitted to the hospital where Dr P practiced. After admission to the hospital, Mr C was treated with antibiotics for community-acquired pneumonia.
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What’s behind all these assessments of digital health?
The Healthcare Blog
APRIL 29, 2024
Their logic always goes something like “XY% of patients used our solution, most of them like it, and after they use it hospital admissions and ER visits go down, and clinical metrics get better”. Also worth a mention that many of those insurers, including Aetna & United have competitive diabetes products too.
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Beyond Hospitals: Where Else Can Medical Assistants Work?
Prism Career Institute
JUNE 1, 2024
While more than half of the medical assistants employed in the United States work in hospitals and medical offices, medical assistants can perform their duties in a variety of settings. The post Beyond Hospitals: Where Else Can Medical Assistants Work? But variety isn’t found only in their responsibilities.
Fake News from MedPac on Medicare Advantage Needs to Be Corrected, Pt 1
The Healthcare Blog
AUGUST 27, 2024
In the world of insurance, having a bid that sets and determines the payment level for the coverage from every plan is a competent, appropriate, intellectually sound, financially legitimate, accurate, and fully functional payment approach and price for Medicare to spend on that coverage as a buyer.
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A New Health Literacy Pillar: Personal Data Stewardship
Health Populi
FEBRUARY 15, 2021
50% of the APIs also allowed her to access inpatient admission records for patients that should not have been accessible to her with the level of authorization she had for the systems being tested. One-half of the APIs allowed Alissa to access pathology, x-rays, and clinical results of patients.
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A Tale of Two States: Idaho, Limiting Health Plan Benefits; and Oregon, Moving Toward Universal Health Care
Health Populi
FEBRUARY 14, 2018
Health insurers in the state are now allowed to offer plans with limited benefits, escaping the rules for plans in the Affordable Care Act that provided for a list of covered benefits. David Cameron, the state’s Director of Insurance, called this strategy, “pushing the envelope” in an interview with NPR last month.
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Why Financial Incentives Oppose Quality Improvement Projects in Healthcare
The Healthcare Blog
JANUARY 15, 2025
All QI projects can be divided into three categories: Category 1: Supported by financial incentives Category 2: Neutral to financial incentives Category 3: Opposed by financial incentives Determining which category a potential project will fall into is important for predicting how much support from hospital leadership a QI project will have.
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Health Care In the COVID-19 Era – PwC Finds Self-Rationing of Care and Meds Especially for Chronic Care
Health Populi
MAY 20, 2020
The concerning learning here is that the self-rationing, or postponing, health care behaviors of millions of patients dealing with chronic conditions can exacerbate those issues, from foot health to vision health, delayed diagnoses for acute conditions, or un-managed care that will occasion an inpatient admission later in 2020.
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Expectations of Medical Assistants in the OB/GYN Field
Prism Career Institute
JULY 23, 2024
OB/GYN medical assistants can be found in physician offices, family planning centers, hospital outpatient clinics, urgent care, health maintenance organizations (HMOs), and more. You can contact us for more information on our program and its admission requirements.
Doing Less Can Be Doing More for Healthcare – the Biggest Takeaway From ASCO 2018
Health Populi
JUNE 5, 2018
Brownlee, now an SVP at the Lowns Institute and Co-Founder of the Right Care Alliance, pointed out the dangers of super-sized medicine, from unnecessary radiation exposure and hospital infections to medical errors and duplication of services. It’s not enough to open up doctors notes to patients.
Top 27 Medical Terms Every Medical Assistant Should Know
Prism Career Institute
FEBRUARY 11, 2025
A good understanding will help you succeed in a variety of areas: Accurately and efficiently fulfilling physician requests Communicating effectively with other team members Requesting funding from insurance companies Educating patients and their families Medical terminology can sound like another language at times.
RETAIL PHARMACY VS INSTITUTIONAL PHARMACY
CareerStep
MAY 27, 2024
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.
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UnitedHealth Group Confirms Data Stolen in Change Healthcare Ransomware Attack
The HIPAA Journal
MARCH 29, 2024
billion in loans to healthcare providers under its temporary funding program to help ease the financial strain caused by delays to the processing of insurance claims and providers will have 45 days to pay back the loans. United Health Group has also confirmed that it has paid out more than $3.3 40% of the $3.3
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A People Person: 4 Ideal Medical Assistant Personality Traits
Prism Career Institute
OCTOBER 6, 2024
Medical assistants are trained support staff found in hospitals, nursing facilities, and medical organizations everywhere. Contact us to learn more about admissions requirements or to get started. Here, we introduce the four most important personality qualities of a medical assistant. What Do Medical Assistants Do?
Healthcare Workers are In-Demand
Milwaukee Career College
APRIL 17, 2020
However, with the pandemic, hospitals need medical assistants more than projected estimates, which means that workers in the medical field may enjoy job security for many years to come. If you would like to learn more, talk to a Milwaukee Career College admissions advisor today. You can also train to become a surgical technician.
Optimizing Revenue Cycle Management and Clinical Documentation Integrity To Avoid Coding Disasters
Relias
JUNE 1, 2022
Undercoded Complex Hospital Admissions. Coders are challenged to select the codes that best convey the reason for admission. Coders are having difficulty coding all of the aspects of the admission that they really should,” said Bowman. Providers are trained to document from a clinical care standpoint.
Optimizing Revenue Cycle Management and Clinical Documentation Integrity To Avoid Coding Disasters
Relias
JUNE 1, 2022
Undercoded Complex Hospital Admissions. Coders are challenged to select the codes that best convey the reason for admission. Coders are having difficulty coding all of the aspects of the admission that they really should,” said Bowman. Providers are trained to document from a clinical care standpoint.
Medical Assistant Tasks and Specializations: Discover the Diverse Medical Assistant Field
Northwest Suburban College
APRIL 4, 2024
From clinical procedures to administrative duties, the expertise of a medical assistant is essential in ensuring the smooth functioning of medical offices, clinics, and hospitals. – Medical Administrative Specialist: Focuses on advanced administrative duties, such as insurance coding, medical transcription, or medical office management.
Fake News from MedPac on Medicare Advantage Needs to Be Corrected, Part 2
The Healthcare Blog
AUGUST 29, 2024
We know that the plans have 40% fewer hospital admissions for congestive heart failure, and almost 80% lower amputation rates for the lowest income diabetic members, and we know that the plans use those savings from better care to also to provide much better benefits for all of the members.
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10 Steps To Optimize Your Revenue Cycle Management
Relias
JUNE 1, 2023
However, large technology investments aren’t always realistic in the near term when hospitals and health systems are struggling financially. If the scheduling team doesn’t collect accurate insurance, for example, an entire claim can get denied. “A About 30% of payers require these notifications.
10 Steps To Optimize Your Revenue Cycle Management
Relias
JUNE 1, 2023
However, large technology investments aren’t always realistic in the near term when hospitals and health systems are struggling financially. If the scheduling team doesn’t collect accurate insurance, for example, an entire claim can get denied. “A About 30% of payers require these notifications.
Get ready for CPT codes changes in 2024
Health Prime
JANUARY 10, 2024
These descriptors are an essential resource that hospitals, medical practices, health plans, and other CPT users can incorporate into English-language documents, such as insurance forms, price sheets, medical records, patient portals, and more.
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Fee-For-Service: Predominant, Winning & Stupid
The Healthcare Blog
MARCH 4, 2024
First, several health insurers who sold their reputation to Wall Street as being wizards at understanding how doctors and patients behave had the curtain pulled back to reveal the man pulling the levers was missing a dashboard or dial or three. Yes, all these patients are being billed or misbilled for individual procedures and visits.
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The Key Role of Medical Assistants in Primary Healthcare: Serving as the Backbone of Clinical Operations
Northwest Suburban College
MARCH 8, 2024
Their key tasks include: Administrative Duties: Medical Assistants handle essential administrative tasks such as scheduling appointments, managing patient records, and conducting insurance billing to keep the practice running efficiently.
All You Need to Know about BU’s Chobanian & Avedisian School of Medicine
Accepted Blog
SEPTEMBER 19, 2023
If you want to know how much of BU medical school’s recent $100 million gift it intends to use for scholarships, or what happens to applications to ensure a genuinely holistic process, or what its associate dean of admissions wants to see in students read on! Welcome to the 541st episode of Admissions Straight Talk.
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Interoperability In Healthcare: What You Must Know
Arkenea
MARCH 15, 2025
Interoperability within an Organization A hospital’s IT systems communicate with each other and share data to improve care and efficiency. These can include messages that inform patients about admissions, tracking medication orders or lab results. They will then have to request authorization from the insurance company.
How to Become an Oncology Medical Assistant
Prism Career Institute
MARCH 1, 2024
These codes are extremely important to medical billing procedures, and proper use can help reduce the amount of paperwork patients receive from their insurance companies. They can find work in almost any healthcare setting, including medical center research studies, private physician practices, public health clinics, and hospital departments.
False Claims Act Update: A Mid-Year Review (2023)
Healthcare Law Insights blog
JULY 7, 2023
The Supreme Court issued a number of headline-grabbing decisions this term on topics like religious accommodation , LGBTQ protections , and consideration of race in college admissions. The decision may have benefited him, but the hospital never offered him anything at all. The hospital simply left things where they were.
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How To Become A Medical Assistant?
MedAssistantEDU.org
SEPTEMBER 16, 2021
Depending upon the working facilities like physician’s offices, clinics, hospitals, or other healthcare facilities, medical assistants have to fulfill several job responsibilities. Having updated records also help with treatments and claiming health insurance.
SDOH Data: Use Cases, Maintaining Privacy, and Health Data Ecosystems
Ciox
JULY 20, 2023
By identifying patients with complex needs or those at risk for re-admission, healthcare providers can focus their efforts on high-risk patients, improving care coordination and reducing unnecessary hospitalizations. Predictive analytics can also be used to optimize care management and resource allocation.
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