HIT Consultant

MAY 2, 2023

Andy Auerbach, Chief Revenue Officer of SafeRide Health As the healthcare industry continues to evolve, there is a growing need for innovative solutions that not only improve the quality of care but also make care more accessible. adults without access to a vehicle or public transportation skipped needed medical care last year.

Medicaid 96

Medicaid Regulations Medicare Integration 96

Meditech

MAY 26, 2022

Hospital patient experience surveys, such as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), measure the quality of care given by a hospital, which influences patient satisfaction and retention.

Patient Experience 104

Patient Experience Quality of Care Medicare Hospitals 104

Home Health Care

SEPTEMBER 29, 2021

“In response to the pandemic, there has been much more attention paid to this particular sector of personal care, home care, but also let’s take a look at Medicare Advantage (MA) plans,” she said. “A A couple of years ago when they were permitted to pay for personal care in the home, we saw a slow uptick in that.

Home Care 103

Home Care Regulations Nursing Medicare 103

HIT Consultant

OCTOBER 18, 2023

Hilton Hudson, MD, FACS, and CEO of HPC International In May 2022, a California doctor was sentenced to nearly eight years in prison for his involvement in a $12 million Medicare fraud scheme. million in reimbursements from Medicare over a three-year period. He received $4.5

Regulations 105

Regulations Accountable Care Prevention Medicare 105

Home Health Care

OCTOBER 11, 2024

That was the one-word response a home health provider left for the Centers for Medicare & Medicaid Services’ (CMS) during the comment period on the 2025 home health proposed payment rule. The result of amputation resulted in significantly higher expense to Medicare than paying for adequate wound care wound cost.

Medicare 105

Medicare Nursing Hospitals Regulations 105

Briggs Healthcare

FEBRUARY 9, 2022

The Medicare and Medicaid certification of providers and suppliers in a State whose oversight process is substantially deficient may be jeopardized if CMS cannot ensure that the regulatory minimum health and safety standards have been met.

Medicaid 52

Medicaid Medicare Regulations Quality of Care 52

Cloud Blogs

FEBRUARY 28, 2022

These shifting priorities have catalyzed the desire to track patient outcomes and cost-savings for improved quality of care. In 2020, the Centers for Medicaid and Medicare Services (CMS) issued additional rules requiring that payors and providers who receive CMS funds make health information more accessible.

Integration 127

Integration Healthcare Quality of Care Regulations 127

Home Health Care

MARCH 9, 2022

health care system has learned that home-based care companies are well-positioned to respond to unique challenges, with at-home care approaches often boosting patient satisfaction, lowering costs and improving quality of care. Over the past few years, the U.S.

Home Care 85

Home Care Regulations Urgent Care Hospitals 85

Home Health Care

JUNE 17, 2024

Some have decided to take on more payer sources like Medicaid and Medicare Advantage, some have looked to drive efficiencies to keep private-pay costs down, and others have decided to tailor their business to the most wealthy. Many have also taken shades of each strategy.

Home Care 94

Home Care Medicaid Medicare Quality of Care 94

Briggs Healthcare

MARCH 2, 2022

The purpose of this primer is to provide updated information to the patient safety community about the challenges of ensuring the safe care of older adults in Medicare and Medicaid certified nursing homes (NHs) associated with the COVID-19 pandemic, and the federal and state efforts taken to mitigate these challenges. Conclusion.

Nursing 75

Nursing Patient Safety Quality of Care Regulations 75

Home Health Care

JULY 19, 2024

However, there’s a difference between providers that have made errors in claims processing or quality of care provisions versus those taking part in purposeful fraudulent activity, according to National Association for Home Care & Hospice (NAHC) President William A.

Regulations 91

Regulations Home Care Quality of Care Medicaid 91

Home Health Care

DECEMBER 7, 2023

Increased capacity for predictive modeling through AI will empower home care leaders to enhance service offerings to improve the quality of care, patient health, comfort and independence. Baseline regulations that set forth good business practices to keep clients and caregivers safe are essential.

Home Care 113

Home Care Regulations Nursing Prevention 113

Home Health Care

JUNE 28, 2022

Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) are taking steps to improve oncology care and primary care this week. While both are not directly related to home-based care, the federal government pushing this should pique providers’ interest.

Primary Care 87

Primary Care Medicaid Medicare Quality of Care 87

Briggs Healthcare

JANUARY 20, 2023

CMS performs over 100,000 compliance surveys of Medicare and Medicaid-certified providers and suppliers, each year. The intent of this initiative is to provide a resource for providers and suppliers to proactively address common compliance concerns and therefore increase the quality of care for patients and residents.

Quality of Care 52

Quality of Care Regulations Medicaid Prevention 52

Home Health Care

JANUARY 17, 2022

The end of 2021 brought a handful of key home health policy issues to a temporary conclusion, including the congressionally secured delay to Medicare sequestration. One of the most recent ones is Medicare sequestration. Because it’s again, delaying that 2% Medicare sequestration cut, but also PAYGO requirements as well. [00:01:27]

Integration 98

Integration Home Care Medicare Medicaid 98

Home Health Care

SEPTEMBER 25, 2024

This holistic view enables more tailored care.” The Centers for Medicare & Medicaid Services (CMS) launched the Acute Hospital Care at Home waiver during the pandemic, which created a payment system for HaH through Medicare. Most private payers do not cover hospital-level care in the home.

Hospitals 109

Hospitals Medicare Patient Safety Nursing 109

Briggs Healthcare

AUGUST 14, 2023

The SPSS is aligned with CMS expectations for State Survey Agency performance in accordance with the §1864 Agreement and all related regulations and policies intended to protect and improve the health and safety of Americans such as the State Operations Manual, the Mission and Priority Document, survey procedure guides, and other relevant documents.

Physical Therapy 52

Physical Therapy Rehabilitation Medicaid Quality of Care 52

Home Health Care

APRIL 14, 2022

million more people than a year ago across its health benefits offerings, with growth driven by strong enrollment in Medicare Advantage (MA), D-SNPs and the broader Medicaid market. “We’re The quality of care that they provide is remarkable.”. Overall, UnitedHealthcare in the first quarter served about 1.5

Quality of Care 101

Quality of Care Regulations Medicaid Medicare 101

Home Health Care

APRIL 23, 2024

This article is a part of your HHCN+ Membership On Tuesday, Centers for Medicare & Medicaid Services (CMS) officials vehemently backed the thought process behind the “80-20” wage mandate in home- and community-based services (HCBS). Providers and advocates, on the other hand, continued to argue that the policy could be disastrous.

Home Care 99

Home Care Medicaid Law Firms Quality of Care 99

Icanotes

MARCH 15, 2021

Beyond providing high-quality patient care, behavioral health clinicians need to navigate challenges in mental health services, such as changing regulations and an increasing shift to telemedicine. Ensuring Compliance With Regulations and Practicing Risk Mitigation. Table of Contents. Shifting to Telehealth.

Telemedicine 98

Telemedicine Regulations Doctors Quality of Care 98

Briggs Healthcare

MARCH 17, 2022

The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS’ intention to collect information from the public. The ICs specified in the regulations may be used as a basis for determining whether a LTC is meeting the requirements to participate in the Medicare program.

Medicaid 52

Medicaid Medicare Nursing Quality of Care 52

Home Health Care

APRIL 22, 2024

The White House teased the finalized Medicaid Access Rule early Monday, and the Centers for Medicare & Medicaid Services (CMS) later revealed more intricate details attached to the rule. While the current administration has been supportive of the idea of enhanced home-based care services in the U.S.,

Medicaid 67

Medicaid Home Care Quality of Care Medicare 67

Briggs Healthcare

NOVEMBER 17, 2022

GAO also reviewed relevant statutes, regulations, and VA documents, and interviewed federal and state officials and organizations involved with veteran care. The Department of Veterans Affairs (VA) is the only federal entity that oversees all 153 state veterans homes, which provide nursing home care to roughly 14,500 veterans.

Home Care 52

Home Care Nursing Regulations Medicaid 52

Home Health Care

JANUARY 9, 2023

She shares some best practices for building a wound care management program in today’s operating environment, and she also discusses the key ways in which providers can cut costs without sacrificing quality of care. Home Health Care News: What career experiences do you most draw from, in your role today?

Regulations 82

Regulations Nursing Medicare Quality of Care 82

NCQA

JULY 31, 2024

Many of our HEDIS measures are used in quality reporting and value-based purchasing by Medicare, Medicaid and commercial insurance plans. Network adequacy standards vary from state to state, as do the systems state regulators use to ensure compliance with those standards.

Quality Assurance 52

Quality Assurance Regulations Quality of Care Medicaid 52

Home Health Care

JUNE 28, 2023

Riggins is a veteran of the home health space, but has been thrust into RCD given the VitalCaring’s footprint in Texas and Florida, two of the five states where the Centers for Medicare & Medicaid Services (CMS) demonstration is active. After a year, Riggins realized VitalCaring was well above the 90th percentile in Medicare billing.

Home Care 71

Home Care Regulations Medicare Quality of Care 71

Briggs Healthcare

SEPTEMBER 17, 2021

QM Reports now include two measures based on Fiscal Year 2018 and 2019 Medicare claims data: the Hospice Care Index (HCI) and Hospice Visits in the Last Days of Life (HVLDL). Hospices can use the QM Report to learn about HCI and HVLDL and begin efforts to improve quality of care.

Hospice Care 40

Hospice Care Quality of Care Regulations Medicare 40

Cloud Blogs

FEBRUARY 28, 2022

These shifting priorities have catalyzed the desire to track patient outcomes and cost-savings for improved quality of care. In 2020, the Centers for Medicaid and Medicare Services (CMS) issued additional rules requiring that payors and providers who receive CMS funds make health information more accessible.

Integration 73

Integration Healthcare Quality of Care Regulations 73

NASHP

OCTOBER 22, 2021

Arizona’s End of Life and Advanced Care Planning benefit is referenced in its MCO contracts and further described in state regulations. In Rhode Island, MCO plans of care must include “interventions to address special needs (e.g., Enhance federal advance care planning requirements. Quality and performance measures.

Medicaid 102

Medicaid Hospice Care Regulations Integration 102

NCQA

JUNE 28, 2024

The Centers for Medicare & Medicaid Services (CMS) recently announced two major updates to Medicaid regulations. This blog will delve into their significance and key policy implications for states and managed care organizations (MCO).

Medicaid 59

Medicaid Regulations Care Transition Primary Care 59

Home Health Care

OCTOBER 9, 2023

And lastly, there’s the quality of care that is being delivered now because the standards are higher. There’s more visibility and there’s more transparency about all the care that’s been developed. What degree of progress has the home-based care field made in communicating their value to payers, in your view?

Regulations 94

Regulations Home Care Quality of Care Medicaid 94

HIT Consultant

MARCH 17, 2024

Jay Ackerman, CEO, Reveleer The momentum of value-based care (VBC) is poised to accelerate. The Centers for Medicare and Medicaid Services (CMS) has outlined an ambitious objective: to transition all traditional Medicare beneficiaries into a VBC arrangement by 2030, a notable increase from the mere 7% recorded in 2021 by Bain Research.

Quality Improvement 64

Quality Improvement Medicare Quality of Care Regulations 64

Home Health Care

DECEMBER 1, 2022

Even in those states that do regulate hospice and home health through certificate of need law, their processes vary greatly. It includes some of the built-in payment challenges and the reliance, to a large extent, by home health agencies on Medicare fee for service. Payer engagement.

Law Firms 105

Law Firms Medicare Medicaid Home Care 105

NASHP

JANUARY 12, 2024

In 2024, people with Medicare and Medicaid coverage (i.e., dual eligibles) will continue to enroll in integrated managed care special needs plans or D-SNPs (Dual-Eligible Special Needs Plans). A NASHP analysis shows that in 2024, at least 22 states are planning to sustain these payment increases post-pandemic.

Medicaid 64

Medicaid Nursing Accountability Integration 64

Briggs Healthcare

MARCH 10, 2022

LTCCC’s Q3 2021 report can help the public, media, and policymakers identify and assess the extent to which nursing homes in their communities provided sufficient staffing to meet basic clinical and quality of life needs. See: PBJ Daily Nurse Staffing and PBJ Daily Non-Nurse Staffing ).

Nursing 52

Nursing Quality of Care Accountability Regulations 52

Briggs Healthcare

JULY 25, 2023

Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare “Last week, regulators rolled out enhanced oversight for new hospices in Arizona, California, Nevada and Texas. Others appeared to be billing Medicare for “phantom” — that is, nonexistent — patients. Some did both.

Hospice Care 40

Hospice Care Regulations Medicare Medicaid 40

Briggs Healthcare

MARCH 9, 2023

On May 16, 2022, HHS announced the funding opportunity of nearly $15 million for a three-year federal grant to establish a Substance Abuse and Mental Health Services Administration (SAMHSA) program that will strengthen the delivery of behavioral health care to residents of nursing homes and other long-term care facilities.

Nursing 52

Nursing Prevention Performance improvement Medicaid 52