The pain radiated from the top of Annette Monachelli’s head, and it got worse when she changed positions. It didn’t feel like her usual migraine. The 47-year-old Vermont attorney turned innkeeper visited her local doctor at the Stowe Family Practice twice about the problem in late November 2012, but got little relief. Two months later, … [Read More]
Patient is King: A Patient-Centered Approach to Value
The American healthcare industry is going through an unprecedented transformation. The current fee-for-service model, historically focused on disease management, is rapidly evolving to an outcome-based system. All healthcare constituents, whether a physician practice, hospital, lab, nursing facility, or a payer, are currently designed to support a patient interaction or a visit. The massive change from … [Read More]
Countdown to 2014 Healthcare in Transition
By Jack Duffy Executive Vice President As we prepare to enter into a new year, we cannot help but reflect on the challenges 2013 brought to healthcare organizations. Many were required to reduce staff and say “good luck” to trusted colleagues. Unfortunately, the productive work these employees did every day remains for the ongoing team … [Read More]
2014 OPPS Final Rule Outcome for Collapse of E/M Levels
For 2014 CMS has finalized the collapse of the clinic visit codes. They have opted to not include Type A or B ED visits at this time. The national reimbursement rate for G0463 under APC 0634 is $92.53. CMS will continue to explore the ED visits and address in future rule making. For now, hospital … [Read More]
How Do Hospitals Operationalize the Two Midnight Rule?
Patient status is not new, the Medicare defined outpatient, observation and inpatient status has been in place for many years. This rule is to help practitioners and facilities identify and document the physician’s decision to have the patient treated in an outpatient (observation) or inpatient status. Operationally, the provider takes into account the patient’s history, … [Read More]
