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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. Recently, I interviewed industry experts who discussed these issues in depth during a live recording of The Better Care Podcast.

Hospital 130
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What I Read This Week

Sensible Medicine

In a multinational, open-label, randomized, parallel-group trial, patients aged 18–85 years, admitted to hospital with acute heart failure, were randomly assigned to either usual care or high-intensity care. High intensity care was the GDMT group. 1078 patients were randomized and the study was stopped early.

Follow-Up 286
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Friday Reflection 41: Sometimes I Just Need to Complain

Sensible Medicine

A 76-year-old woman presents to a community hospital after waking with garbled speech and right-sided weakness. Case 1: Excess An elderly woman is admitted to a community hospital with a minor stroke. The hospital does an excellent job. By the time she leaves the hospital, she has no residual symptoms. I love my job.

Follow-Up 264
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Understanding DRG Codes and Their Impact on Hospitals

EvidenceCare

In our efforts to empower hospital clinicians to provide better care by having real-time transparency to cost and benchmark utilization data, we’ve learned that one of the core code systems that defines modern hospital resource management – Diagnosis-Related Groups (DRG) – is misunderstood or even unknown.

Hospital 130
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3 Old-School Nursing Methods That Need to Go Away

Scrubs

But sometimes, medical facilities and the nurses that work there can fall a bit behind on the most up-to-date approaches to patient care. Evidence-based practice is the conscientious use of up to date evidence in making decisions about patient care. Joseph’s Hospital Health Center in Syracuse, New York.

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Patients Allegedly Sleeping in Tents Due to Overcrowding

Scrubs

The union alleges that management is keeping patients in hallways and other areas that aren’t meant for patient beds. And the nurses said they “are deeply concerned about eroding patient care conditions and the lack of patient privacy and dignity.” This makes it difficult to navigate the facility.

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Beyond Care and Outcomes, Hospitals Must Deliver on Civics, Inclusivity, Equity, and Value – Lown Institute’s Best Hospitals

Health Populi

The core business of hospitals is patient care, often baked with teaching and research. But wait — there’s more, asserts the Lown Institute in their approach to ranking America’s Best Hospitals in 2020. In fact, hospitals whether non- or for-profit scored similarly for community benefit and inclusivity.