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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.

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Navigating the Complexities of Social Admissions in Healthcare

EvidenceCare

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. Hospitals should develop a plan for care beyond their walls, but few invest in skilled nursing facilities.

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Can We Select “Better” Residents?

Sensible Medicine

There are many more people competing for slots in medical school and residency and the number of “slots” have increased at a slower pace than the applicants. If applicants are more impressive on paper, but no more impressive in the clinics and hospitals, aren’t we doing something wrong? programs is even stiffer.

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STRONG HF – A Positive Trial that Does Not Help Clinical Medicine

Sensible Medicine

The worry I have about medical science is that a lot of our experiments produce little to no knowledge. The Trial STRONG-HF studied two treatment strategies after a patient was discharged from the hospital after treatment for heart failure. The primary endpoint (of hospital readmission for HF or death) occurred in 15.2%

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How Innovative Health Tech Can Reduce Hospital Re-Admission Rates

Electronic Health Reporter

By Geoff Gross, founder and CEO, Medical Guardian. The Hospital Re-admissions Reduction Program took effect in 2012 with the goal of sustainably lowering hospital re-admission rates. The article How Innovative Health Tech Can Reduce Hospital Re-Admission Rates appeared first on electronichealthreporter.com.

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When Bias Turns Deadly: How Medical Bias Killed My 5-Year-Old Daughter

Scrubs

You may wonder how my husband lived almost 40 years and had three kids without ever being diagnosed – simple medical bias. If it weren’t for my medical education, we would have never known my children and husband had EDS and MCAS. often attributed to other conditions, not EDS. I am a doctor in the U.S.

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Most Important

Sensible Medicine

He was a direct admission after an electrophysiologic (EP) study. They found a medication that made it harder to induce VT and sent him up to the medical floor for admission and monitoring with instructions to initiate that medication. It was probably the medication.”

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