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Navigating Medicare Advantage: Strategies for Hospitals to Tackle Growing Challenges

EvidenceCare

CMS Policy Changes to Reduce Costs Financial pressures are rising as CMS implements the updated Version 28 Hierarchical Condition Category (HCC) model , which introduces changes aimed at limiting types of codes that are most used for up-coding or over-coding to help rein in spending. MA plans are looking for contradictions in provider notes.

Hospital 130
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Universal Depression Screening Leads to Unnecessary Harm

Sensible Medicine

The USPSTF claims "screening interventions" decrease the prevalence of depression at six-month follow-up by an odds ratio of 0.60. This number is surprising when we consider the following: A meta-analysis of six RCTs found the benefit of SSRIs, compared to placebo, to be small and statistically insignificant at six months.

Follow-Up 360
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Friday Reflection 41: Sometimes I Just Need to Complain

Sensible Medicine

What there was -- courtesy of colleagues from across the country – were cases illustrating needless excess, careless follow-up, poor commitment to clinical care, and the devaluation of primary care that undermines our entire system. She is discharged on dual-antiplatelet agents and an increased statin dose.

Follow-Up 266
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Nurse Researcher Wants to Change How Providers Think About Health Literacy

Scrubs

If patients are having trouble following the latest health recommendations, providers can engage with the community to better understand why these problems persist. Yet, every time they would come into the hospital, we would discharge them with the same plan. has a health literacy problem of its own.

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The Craziest Medical Bills

Scrubs

Patients around the country are getting stuck with enormous medical bills as hospitals continue to mark up the cost of their services, including those for routine medical procedures and advanced surgeries. He ended up staying in the hospital for four days and came out with a bill for over $100,000. Total healthcare spending in the U.S.

Billing 245
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AI is Transforming Healthcare Behind the Scenes

Mobius MD

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.

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On Other Channels.

Connect Care Bytes Blog

General Connect Care Satisfaction Follow-Up Survey [open until March 31] Netcare Update - Connect Care Clinic-Administered Medication Information FAQ Why were my discharged patient's DI orders cancelled?