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Hip And Knee Replacement: Home Discharge Insights

Large studies support that patients sent home after knee and hip replacements do not have higher rates of medical complications, returns to the hospital or emergency room visits than those who went to rehabilitation facilities. By: Lisa Remington, President, Remington Health...

EHR Incentives for PAC Providers: What Will CMS Recommend?

The post-acute sector was overlooked when federal incentives were offered for EHR adoption. Providers in the post-acute setting weren’t eligible for the Medicare and Medicaid EHR Incentive Programs. To date, the federal government has spent more than $35 billion under the Medicare and Medicaid EHR...

The Relationship Between Sepsis and Readmission Penalties May Surprise You

The Hospital Readmission Reduction Program (HRRP) follows 30-day readmissions for acute myocardial infarction (AMI), heart failure, chronic obstructive pulmonary disease (COPD), and pneumonia. Perhaps what isn’t widely known is the association of Sepsis with these four conditions. In a Journal...

Readmission Data For All Cause 7-Day and 30-Day

Is 30-days the right interval for your organization to be measuring readmissions? 30-day risk-standardized, all-cause, unplanned readmission rates is widely used to measure hospital penalties. Yet, many question if this is the correct interval by condition. For both 7-day and 30-day...

Which Patient Populations Cause The Highest Readmissions?

In the third year of the Hospital Re­ad­mission Reduction Program (HRRP) (FY 2015), the proportion of hospitals receiving a penalty increased to 78 percent – up from 64 percent and 66 percent in 2013 and 2014 respectively. This increase is not surprising given that for 2015 penalties, CMS...

The Five Barriers to Accessing Palliative Care

Barriers to palliative care access in the United States occurs in five domains: By: Lisa Remington, President, Remington Health Strategy Group, and Publisher, The Remington Report Lack of AwarenessThe misperception among doctors and other health professionals that palliative care is...

Key Elements of a Successful Home-Based Palliative Care Program

By: Lisa Remington, President Remington Health Strategy Group, Publisher, The Remington Report The 2014 report “Dying in America,” by the Institute of Medicine, recommended that all people with serious advanced illness have access to palliative care. Many hospitals now have palliative care...

Standardizing Palliative Care Consultations

By: Lisa Remington, President, Remington Health Strategy Group, and Publisher, The Remington Report A study demonstrated that increased palliative care consultations for patients with advanced cancers is associated with substantial impact on 30-day readmission, administration of chemotherapy...

22 Key Facts About Physician CCM Billing

Frequently Asked Questions about Physician Billing for Chronic Care Management Services.  This document answers frequently asked questions about billing chronic care management (CCM) services to the Physician Fee Schedule (PFS) under CPT codes 99487, 99489 and 99490. January 18...

ACOs: Three Approaches To Improve End-of-Life Care

The ACO model has the right incentives to reduce variation, spur innovation, and improve quality in end-of-life (EOL) care. It also gives providers and delivery systems the flexibility to expand access to palliative care outside of the Medicare hospice benefit by encouraging ACO providers to...

Home-Based Palliative Care Models

Palliative care focuses on relieving patients’ stress, pain and other symptoms as their health declines, and it helps them maintain their quality of life. It’s for people with serious illnesses, such as cancer, dementia and heart failure. The idea is for patients to get palliative care and then...

Identifying Key Transformation Trends in Bundled Payment Initiatives

Trend tracking can support your strategic planning and de-risk your future. Taking place right now are trends preparing the continuum of care for bundled payments. We take a look at significant changes to come...
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How Is Medicare Spending Per Beneficiary Linking Providers Across The Continuum

40% of the spending that comprises the Medicare Spending Per Beneficiary (MSPB) measure is accumulated outside of inpatient hospitalization. MSPB will be a quality measure across the healthcare continuum starting in 2017.
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The ACO Medicare-Medicaid Model For Managing High-Risk Patients

Some of the highest-need, highest risk Medicare beneficiaries are those enrolled in both Medicare and Medicaid.  In current Medicare ACO initiatives, beneficiaries who are Medicare-Medicaid enrollees may be attributed to ACOs. The Medicare ACO, however, does not have financial...

Patient Activation Measures For High-Risk Patients

Patient "activation scores" can identify those who might benefit from help making behavioral changes.  After reviewing medical records for approximately 98,000 adults, researchers found that patients who did not feel competent to manage their own health or navigate the health care system were...

How Do ACOs Address The Non-Medical Needs Of Patients?

ACO leaders identify and provide insights to how they are addressing the non-medical needs of patients. We explore key areas of transportation, housing and food insecurities. We take a look at CMS’ solutions and ways to solve barriers.
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Should Your Organization Look At Readmissions Prior To 30-Days?

Recent research suggests readmissions are higher within the first several days after discharge reaching its lowest point around seven days. Take a look at the analysis and check it against your own data.
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The Impact Of High Healthcare Spenders In Value-Based Care

As health system reform shifts payment away from fee-for-service to value-based care models, the incentives to focus on and improve care for high-cost patients will grow.
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The Five Barriers To EHR Use In Post-Acute Settings

Why are there not more post-acute providers using EHRs? Identified in this article is the GAO report about the five current EHR barriers and why the government’s overall plan is impacting usage.
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Are Medicare Advantage Plans The Next Big Play For Post-Acute?

Medicare Advantage now covers almost a third of all Medicare beneficiaries. In this article, we explore the importance of why Medicare Advantage Plans should coordinate with post-acute providers.
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What Does It Take To Be A Great Leader In Times Of Change?

In our insight series, we asked three successful healthcare organizations to tell us what they think it takes to achieve excellence amid the industry’s rapid changes. We share with you how these leaders are adapting, setting new direction, and embracing change. We interview: Joan Doyle, RN...

Primary Care Is Driving Care Coordination: Market Changes Ahead

Market conditions are sending strong signals about changing responsibilities and payments physicians will have for managing patients beyond the four walls of their offices. We explore three key game changing trends.
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Physician Practice Transformation: A Primer on MIPS and APMs

The Medi­care Access and CHIP Reauthori­zation Act (MACRA) went into law over a year ago. CMS released the first major regulation under MACRA, set­ting forth the new rules under this game-changing law. For now, only physician offices – not hospitals – are governed by MACRA rules. CMS...

End-of-Life Medicare Spending And The Cost Of Care Insights

Of the 2.6 million people who died in the U.S. in 2014, 2.1 million, or eight out of 10, were people on Medicare, making Medicare the largest insurer of medical care provided at the end of life. Spending on Medicare beneficiaries in their last year of life accounts for about 25% of total...

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