Nalashaa Healthcare Blogs
Since the Meaningful Use initiatives of 2009, Healthcare Information Technology (HIT) development has been driven by continually evolving healthcare regulations. The Interoperability and Patient Access Final Rule & the 21st Century Cures Act Final Rule, released in 2020, continue this trend. HIT’s role in improving care outcomes and managing the pandemic is far too important to…
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The ONC issued a final rule on March 9th, 2020, to hold entities who interfere with, prevent, or materially discourage the access, exchange, or use of electronic health information (ePHI), accountable. It was the Information Blocking final rule, and it affected healthcare providers (Hospitals, SNFs, LTCH, Mental Health Centers, and more), ‘Certified Health IT’ developers, (Certified EHR developers), and HIEs. The…
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Although at the beginning of the 21st century, many businesses had started to focus on data, the COVID–19 pandemic has forced organizations to develop and adapt to a must–have data-driven culture at all levels. Data was once a business byproduct for many organizations. Now, data itself is a key driver for decision making in most businesses. Increasingly, many future business decisions will rely on data insights the company gets from its internal and external sources. When the pandemic hit, world economies and organizations went into panic mode because…
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The 2019 Physician Fee Schedule introduced three new CPT codes (#99453, #99454, and #99457) to enable hospitals and home health agencies to qualify for CMS reimbursements. The CMS’s proposed 2021 Physician Fee Schedule, released in August 2020, adds further clarity to how care providers can use the new CPT codes with the existing ones covering…
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ICD-10-CM has been used to document inpatient hospital procedure coding since October 1, 2014. It was introduced as an update to ICD-10. The year 2020 introduces two new changes to the coding system. In this blog, we cover the changes in detail. In July 2020, the CMS released the 2021 ICD-10-CM Official Guidelines for Coding and Reporting.…
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Millions of citizens in the United States rely on the accuracy of Electronic Health Records (EHR) to make crucial decisions about their well-being. EHR systems are the conduits that host, exchange and retrieve patient health records for clinicians, patients and other dependent institutions that are an integral part of the care continuum. When the integrity…
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Consumer satisfaction is paramount to the success of the product or service delivered by a business playing the field in the consumer segment. With increasing competition in the healthcare industry, this key performance variable is crucial to how your patients see you as a care provider. The CMS and the ONC continue to push for…
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We are witnessing a rise in the use of AI/ML concepts and technologies in healthcare. Today, algorithms are already outperforming radiologists at spotting malignant tumors and guiding researchers to construct cohorts for costly clinical trials. There is also an increasing number of investments being made around AI/ML use cases and proofs-of-concept across the healthcare industry. …
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The health of your organization is directly dependent on the health of the members enrolled with it. A holistic view of your members gives you a complete status of their health, enabling you to decipher future patterns in their healthcare. Such levels of visibility are vital to your profitability/prosperity/growth/organic growth. With excellent insights from the…
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Innovations in technology are constant in every industry, and healthcare is no exception to this trend. Healthcare IT (HIT) systems have taken center stage in improving the value of care through meaningful use and the seamless interoperability of patient health information initiatives by the CMS and ONC. HIT vendors must now constantly adapt to regulations without compromising on…
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The Centre for Medicare and Medicaid Services (CMS) has introduced a final rule to update the Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS). The IRF PPS was introduced to cover all the capital costs that IRFs are expected to incur in furnishing intensive inpatient rehabilitation services. The final rule advances the CMS’s vision and…
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The outbreak of COVID-19 has sent shockwaves through the healthcare ecosystem, disrupting many vital healthcare services. Most individuals tested positive for COVID-19 now find themselves in the middle of financial turmoil. Others are gripped by confusion and panic, putting a grinding halt to ‘normal life’ as we know it. Care providers are currently caught in…
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Medical researchers and clinicians seek answers to two evocative questions in their line of work. The first one is, “Why do people suffer from a health problem”? The other is, “What exactly determines recovery?” The hunt for these answers has led to the birth of new healthcare domains such as pharmacokinetics, which reveals how medicines interact…
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The 21st Century Cures Act Final rule was introduced on May 1, 2020. It institutes crucial changes to the definition of Certified Electronic Health Record Technology (CEHRT). This means the current standards that define the format of the structured data which EHR systems use are set to change. We will now take a look at…
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The progress of healthcare technology was primarily driven by the innovative spark of HIT vendors. All great ideas from their research labs and development centers have become a standard in the healthcare industry today. A fine example of this is the integration of data analytics and business intelligence tactics into the Electronic Health Record (EHR)…
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Title IV of the 21st Century Cures Act is dedicated to the enablement of easy access to patient health records for care providers, patients, and payers. Interoperability, transparency in reporting, and preventing all efforts directed to blocking access to patient health records a.k.a information blocking make up the nucleus of this section. With the release…
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Let’s Start with The Bad News COVID -19 has spread to almost every nation in the world since it was first detected in the Wuhan province in China. The United States has over one million cases with 70,000+ deaths and counting. The seemingly ‘intelligent’ behaviour of the virus that causes its meteoric spread before showing…
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The first of this two-blog series on patient-focused healthcare underlines how the US healthcare ecosystem has a lot to be desired from the patient’s perspective. It speaks of how the changing context of the industry is transforming the traditional way of how patients are treated, injecting personalized outreach into the equation. Technological evolution is pivotal…
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The goal of a healthcare delivery system that comprises trained professionals, institutions and resources are to meet the health needs of people. The value of care outcomes lies in the ability of clinicians and doctors to understand patient needs and help restore fitness. Its nature makes it a highly specialized system designed to match the…
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As consumers, we have very distinct and specific preferences. From food to clothing and lifestyle accessories, every choice of an individual is a carefully considered action. Some of the biggest names in e-commerce, hospitality services, consumer electronics and even automotive insurance are now focussing on ‘the individual’. This begs the question. Why should healthcare continue…
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Electronic Health Record (EHR) systems have transformed the way doctors and physicians review patient health records. The dawn of EHR systems also gave federal bodies like the CMS an effective tool to promote value-based care by using EHR data as a reference to determine care quality. EHR vendors continue to evolve their products based on…
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The Comprehensive Care For Joint Replacement (CJR) model was designed to make participant hospitals accountable for both the quality and cost of Lower Extremity Joint Replacements (LEJR) procedures. Hip and knee replacements are two of the most commonly carried out LEJR procedures. With the CJR model, the CMS intended to reward participant hospitals for coordination…
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Artificial Intelligence (AI) has been a prodigious prospect for the healthcare industry for a long time. AI entails the collection of gargantuan amounts of unstructured data. Developers then need to figure out a way to design an algorithm to sift through all this data and make sense out of it. This exercise yields patterns that…
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Home health agencies can now report the costs of Remote Patient Monitoring (RPM) services to Medicare for Reimbursement. The latest update to the 2019 Physician Fee Schedule, the RPM reimbursement final rule introduces vital changes in the form of new CPT codes, vastly improving the prospects for telehealth technology. In 2017, the Centre for Medicare…
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The Center for Medicare and Medicaid Services (CMS) has finalized the hospital price transparency rule. The mandate directs care providers to provide patients with a consolidated list of their standard medical services with their costs before admission. The latest attempt from the CMS to standardize healthcare pricing, the hospital price transparency final rule is more…
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Citizens of the United States have always been in the dark about the cost of their treatment until the moment they receive the bill for it. This ambiguity can be burdensome, often elevating the stress levels of the patient who is already experiencing the unpleasantries of their medical condition. The Department of Health and Human…
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Providing caregivers with mobile functionality increases their frequency of accessing critical patient records. They can use it when performing a wide variety of tasks. From simple tasks like giving out prescriptions to the management of emergencies and complex surgical procedures, mobile devices are always handy during a busy day at the office, doctors say. Unlike traditional…
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The Invaluable Potential of a ‘Mobile Moment’ The rapid and prolific growth of mobile apps can be attributed to one special term that usually doesn’t get the credit that it deserves, ‘Mobile Moment’. In simple terms, a Mobile Moment can be defined as ‘any instance in which a user pulls out a mobile device with…
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On August 2, 2019, the CMS introduced the Long-term Care Hospital (LTCH) Prospective Payment System Final Rule which established highly specific requirements for eligible professionals (EP) from CY 2020. It further advanced the utilization of the Certified Electronic Health Record (CEHRT) based on the requirements of the Medicare and CHIP Reauthorization Act (MACRA), Merit-based Incentive…
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The Elephant in the Room The Centre for Medicare and Medicaid Services (CMS) is going all guns blazing to integrate patient engagement and the interoperability of health information systems with the care continuum. This explains the tall order of proposed rules that the CMS is releasing proactively. Yet, patients who depend on the services of Post-Acute…
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“Great service does not happen by chance, it happens by design”. Every service is made memorable and satisfying with pleasant interactions. It is human nature to appreciate courteousness, which eventually translates to brand loyalty. This is why industries across the world are diverting their focus on customer experience. It is a consumer-driven world out there…
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The Cancer Care Burden The estimated expenditure for cancer care in the United States was $147.3 billion in 2017. In 2016 alone, the estimated number of cancer survivors was 15.5 million and it is set to increase to 20.3 million by 2026. These statistics point to the effectiveness of cancer research and care in the current…
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The Structural Changes in the Second Draft of TEFCA The Office of the National Coordinator for Health Information Technology (ONC), released the second draft of the Trusted Exchange Framework and Common Agreement (TEFCA) for comments, in April 2019. This draft contains important updates to the fundamental structure of TEFCA and the terms and conditions that…
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Let the Games Begin! Computer games and the baby boomer generation have been sworn enemies since these games were released in the second half of the 1980s. American parents fiercely crusaded against the rise of the budding computer gaming industry, calling game developers out for inducing gameplay addiction, promotion of violence and more. With a…
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Understanding the Internet of Medical Things (IoMT) Internet of Medical things or IoMT refers to a system of medical devices that interface with software applications and the internet, with the sole purpose of collecting healthcare data. IoMT can be regarded as a subset of the Internet of Things (IoT) devices, which comprise all web-enabled devices…
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ICD-11 is the latest iteration of the International Classification of Diseases (ICD). It is preceded by ICD-10 and comprises of work completed over 10 years, involving over 300 healthcare industry experts from 55 countries. It was accepted by the members of the World Health Organization in May 2019 and is set to be the official…
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The Quest for Harmonization of Healthcare Quality Reporting Standards The year 2018 was busy and fruitful for the CMS and ONC, the two federal agencies that are responsible for the improvement of healthcare standards of all American citizens. From the release of the Trusted Exchange Framework and Common Agreement (TEFCA) to the announcement of the…
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The Importance of Predictive Models in Clinical Trials Every year in the United States, close to 1.7 million people are diagnosed with cancer for the first time. This makes the recruitment of patients to test the efficacy of potentially life-saving experimental cancer drugs, extremely important. While the efforts from research facilities and hospitals have been…
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Ballistocardiography: Under the Hood Piezoelectric sensors are devices that convert changes in pressure, strain, temperature, and acceleration into electrical charge. These sensors can be embedded in common objects such as a chair or a bed to provide a graphical representation of heartbeat-induced micro-movements of the human body. This method of monitoring the vital statistics of…
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Understanding Clinical Quality Language (CQL) How Healthcare Quality Measures Work The Center for Medicare and Medicaid Services (CMS) employs Clinical Quality Measures (CQMs) to measure the quality of healthcare services provided by eligible professionals, eligible hospitals, and critical access hospitals. Healthcare providers are required to report CQMs electronically (eCQM) by using the data extracted from…
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Currently, the treatment for cancer comprises of a combination of procedures including surgery, chemotherapy, radiation therapy and immunotherapy. Traditionally, these types of treatments have targeted only the type and size of the cancer. While this approach is currently used across most hospitals globally, it is not necessarily the best one. Recent advancements in clinical research…
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Understanding the Epidemic The illegal use of opioid drugs came into focus for the first time in the year 1999. Pharmaceutical companies had begun to recommend opioids for treating patients who suffered from chronic pain in both acute and post-acute care settings. It did not take very long for the dramatic proliferation of opioids as…
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Changes in New York Workers Compensation Regulation: To improve healthcare participation of the providers in the New York State workers compensation system and to improve the condition of injured workers/employees’ access to timely and quality medical care, the New York State Workers Compensation Board (WCB) has decided to adopt Form CMS-1500. This Form is already…
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The Centers for Medicare and Medicaid Services (CMS) has unveiled the Data Element Library (DEL), which is a centralized resource for CMS, allowing the public to view specific types of data that CMS requires post-acute care facilities to collect as part of the health assessment of their patients. Post-acute care settings are currently grappling with…
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The Office of the National Coordinator (ONC) for Health Information Technology has proposed a rule to put into practice the key provisions in the 21st Century Cures Act. The proposed rule breaks down the existing barriers to important data exchange needed to empower patients by giving them access to their own health care. This whitepaper talks about the scope and impact that the proposed rule aims for.
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The new rule laid down by Medicare has included Health and Safety Standards for Home Infusion Therapy and new rules and regulations to administer Infusion Therapy. A considerable amount of change has also been made in the payment system of Infusion Therapy to overcome the issues previously faced by it.
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Medicare has recently adopted a major technological change; Remote Patient Monitoring device, which is a method of healthcare delivery that uses the latest advances in information technology to gather patient data outside traditional healthcare settings.
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The Trusted Exchange Framework and Common Agreement has been initiated by the US Government to streamline data exchange by building a network of Health Information Networks under the management of ONCHIT. The common agreement may include a common method for authenticating trusted health information network participants and a common set of rules for trusted exchange. There are a basic set of principles and terms and conditions proposed in TEFCA to mitigate the challenges faced in data exchange.
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CMS is fixated on reshaping the ACA market that in its 2020 Payment Notice, they proposed a reduction to exchange user fees and potentially eliminates auto re-enrollment and “silver loading,” for which CMS is currently open for feedback.
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The Centers for Medicare and Medicaid Services released the Final Rule of the 2019 Medicare physician fee schedule (MPFS). It mainly includes adding physical and occupational therapists as eligible clinicians for 2019 MIPS performance year.
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Pharmacy Benefit Managers (PBMs) are professionals that administer prescription drug plans for payers, employers, and CMS programs with the goal of lowering prescription drug costs, improving convenience, and ensuring patient safety for payers and their beneficiaries. PBMs reduce prescription drug costs and improve quality for patients, employers, unions, and government programs by: Engaging patients to…
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The technological capabilities have changed the shift from volume to value-based care. The combination of value-based delivery with actionable intelligence and new care delivery models, and value-based payment with new reimbursement models with selected provider networks have pushed providers and payers to operate across a transparent, administratively simple, shared ecosystem. Nalashaa can help in mitigating…
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Utilization Management is an integral part of the US healthcare ecosystem used by health insurers or Pharmacy Benefit Managers (PBMs) to evaluate the appropriateness, medical necessity, and efficiency of healthcare services rendered to patients. Utilization Management aims to: Improve the quality of service at the right cost, in the right setting Address the clinical activities of…
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Headlines on opioid epidemic are engrossing the United States. There are tremendous impacts of opioid overdosage across the care continuum with no single solution. Impacts of Opioid Crisis The opioid epidemic is affecting the United States economy adversely. Opioid over-prescribing is shrinking the number of eligible workers (Krueger, 2017) The Hardest Hit workgroup is between…
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Areas where technology helps providers cope with the new changes Identity Management EMPI solution to detect duplicate records Duplicate records provide a splintered view of patient’s medical history, leading to unnecessary services/tests putting the patient at risk. In addition, many denials are due to the inability to identify patients correctly based on the data provided.…
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The CMS provides issuers with a number of review tools to check their plans for errors in the QHP application that would result in correction notices following submission. Issuers should run each of the below tools, as applicable to their issuer type (e.g. SADP/QHP) before uploading materials to HIOS or SERFF to identify and rectify…
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CMS finalizes the calendar year 2019 and 2020 payment and policy changes for Home Health Agencies and Home Infusion Therapy suppliers. The 374-page rule sets out conditions for home health agencies to be able to participate in federal Medicare and joint federal-state Medicaid programs. Finalized Calendar Year (CY) 2019 Medicare payment updates Finalized quality reporting…
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The Patient Protection and Affordable Care Act (PPACA) and applicable regulations assert that health plans, including SADPs, must meet a number of standards in order to be certified as a QHP. With so many criteria to be met, let us discuss a few guidelines for payers to ensure a seamless QHP certification. QHP Accreditation Things…
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The Affordable Care Act (ACA), defines QHP as an insurance plan certified by the Health Insurance Marketplace which provides Essential Health Benefits (EHBs), follows established limits on cost-sharing, and meets other requirements outlined in the application process. QHPs offer the core set of benefits, including preventive services, mental health, and substance abuse services, emergency services, prescription drugs and,…
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In the previous section we discussed the technologies available to enhance a PHM solution, and how it helps the healthcare industry. Current PHM solutions aim to achieve PHM goals by helping physicians identify care gaps, prevent medical errors and improve patient outcomes. However, there are challenges associated with most PHM solutions. Some of the current…
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Healthcare organizations need to have technological capabilities within their care delivery processes to effectively use data to manage the cost and quality of care. To pursue more aggressive risk-based reimbursement models, these capabilities need to be expanded strategically and proportionately. In the previous post, we discussed the benefits of having a supreme Population Health Management Strategy.…
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Population Health Management is the systematic process of patient data gathering, analyzing and managing patient’s data in the health care system. The changes in the healthcare industry are impacting traditional hospital reimbursement models. Before the introduction of the Patient Protection and Affordable Care Act, hospitals were reimbursed based on the volume of procedures through models like fee-for-service.…
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The data being made available through Blue Button 2.0 initiative provides opportunities to leverage this data for meaningful purposes. Depending on the motivation of the user of these systems, the purpose and approach may differ.
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Blue Button 2.0 is creating a data-centric ecosystem for Medicare beneficiaries. By facilitating access to patient health history, it has the potential to drive down Medicare spending and improve health outcomes.
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With the finalization of the Home Health Grouping Model, the CMS intends to shift from paying for volume to paying for value by eliminating therapy visits as a factor in payment determinations. The HHGM is expected to meet or exceed industry quality standards in healthcare by incentivizing home health providers. It also has the capability to remarkably influence the operations of home health agencies and healthcare industry as a whole.
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The current case-mix adjusted payments under the Home Health Prospective Payment System (HH PPS) are therapy driven, and beneficiaries with low-income, living in under-served areas have a high severity of illness. Ideally, the Home Health (HH) payment should be determined by the patient characteristics and should equally weigh a non-therapy service. In the CY 2018…
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Cloud is the new generation platform that is evolving with a goal to solve traditional problems and to optimize resource utilization. Decades of learning is impeccably implemented in a cloud platform to continuously improve and to meet the demands of modern technology. Applications like Azure update their functions with improvements almost every week to stay…
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Cloud is the new generation platform that is evolving with a goal to solve the problems associated with traditional deployment. The infrastructure on the cloud could be chosen and provisioned in such a way that the costs are optimized. The applications can be deployed on a bare minimum infrastructure and later scaled up depending on…
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Blockchain holds the potential to transform healthcare industry by assimilating the disparate processes in the pharmaceutical industry and healthcare ecosystem. This provides a milestone resulting in reduced costs, improved regulatory compliance, increased data flow, and improved patient experience and outcomes. Let’s have a look at some major use cases of blockchain in healthcare. Interoperability: Cohesive…
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For a data-intensive industry like healthcare sector, blockchain is a reforming technology, which could revolutionize the way data is managed. The traditional way of a centralized database system is vulnerable to attacks from hackers posing major business risks. Blockchain technology could streamline the sharing of medical records in a secure way, protect the patient’s sensitive…
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Though the final version for Interpretive Guidelines is not released, CMS released a draft on the final CoPs for HHAs providing specifics on all the sections under CoPs. Check out our blog to know more.
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Medication adherence is defined by the World Health Organization as the degree to which the person’s behavior corresponds with the agreed recommendations from a healthcare provider. It includes whether patients take their medications as prescribed as well as whether they continue to take a prescribed medication. Typical non-adherence to medications is 50% and 24-90% in mental health. The…
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So far we have discussed the challenges and solutions of MU3 implementation and the process of the certification. To discuss further and to impart knowledge, Nalashaa HealthCare is organizing a Webinar on Medicaid MU3 2018. Through the webinar we intent to share tips and tricks on the fastest path to certification, managing the proctor relationship,…
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In the previous section, we have discussed the challenges while implementing MU3 and the how to solve them like an expert. Now that we have an understanding of the challenges to be expected and the ways to tackle them, we will get into the processes of MU3 certification. Though it might look like a lot…
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According to The Centers for Medicare and Medicaid services (CMS), by the start of 2019, hospitals will be required to use 2015 certified EHR technology. Though, ample time is given for the implementation, there are some major challenges up ahead for the certification, especially when it comes to the thresholds of meeting some of the…
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Blog_Hospital What are the changes for home health EHRs following the new Conditions of Participation (CoPs)? A home health agency (HHA) is an essential component in the healthcare ecosystem when care involves chronic conditions. The new home health Conditions of Participation (CoPs) finalized in January 2017 centers on how HHAs qualify to participate in Medicare…
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Primary care practices have been given the added responsibility of coordinating advanced patient care with physicians, to ensure quality care is delivered, where and when required. More than 10% primary care practices have been recognized as Patient Centered Medical Homes or PCMHs. These would bridge the gap between treatment and coordination. There are some great…
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Value-based reimbursement has reached its tipping point and is here to stay. Of the payers and providers surveyed in the latest McKesson report, just 3% was exclusively fee-for-service. Value-based reimbursement is a proven strategy that will continue to take market share away from fee-for-service operations. What remains, however, are a few questions. How soon is…
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Modern electronic health records (EHR) has come to represent an umbrella term for health information technology (IT). Basically, all the tech running a hospital system. That often means installing separate solutions for each department and cobbling together an interface that fails to truly integrate the data. It’s a system that was designed to support a…
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Here as we wrap up our 3 part series on FHIR, we will discuss the business implications which FHIR brings along with it. If you have not read Part 1 or Part 2, please do so to understand more about FHIR and why it stands for the changing, better times for the healthcare industry. Business…
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In the previous week, we have the Part 1: From HL7 to FHIR, where we discussed about HL7 and the shortcomings which we have all come across while working with it in today’s times. The changing times needed a better and well equipped interoperability standard, from where we have FHIR. Here we shall go deeper…
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In this digital era, every individual wants to see updated health data as he/she moves around the healthcare ecosystem i.e. providers, patients and caregivers should have the data available, discoverable and easily understandable. Furthermore, to support business intelligence, analytics, clinical decision support and other machine-based processing, the data must be structured and standardized in a…
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Chronic care management (CCM) is a recent service eligible for a modest monthly reimbursement from Medicare. While the additional revenue can be healthy for your bottom line, ineffective workflows can quickly drain your potential revenue and even bring you into the red. Smart use of existing electronic health records (EHR) can help close the gap,…
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The new payment model for chronic care management (CCM) offered by Medicare is a positive step toward value-based reimbursement. CPT code 99490, the latest introduction, seems simple on the surface: provide 20 minutes of non-face-to-face oversight and preventative care each month for patients with chronic disease. That requirement, however, belies its true technical challenge. Finding…
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This article explores the benefits of software as a medical device and potential drawbacks. Read more from our blog.
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Understanding how technology has changed healthcare is essential to stimulating future innovation. Read more from our blog.
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MACRA Medicare Access and CHIP Reauthorization Act (MACRA) is an Act that makes fundamental changes to the way Medicare payments to physicians are determined, how they are updated, and how they incentivize physicians. This act: Repeals the Sustainable Growth Rate(SGR) methodology for determining updates to the Medicare physician fee schedule(MPFS), establishes annual fee updates in…
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All the providers will need to take into account the new Final Rule released by CMS in October. Here’s all what you need to know about the Modified Stage 2 for EHR Incentive Program in 2015 through 2017. Goals for the Modification: Align with Stage 3 to achieve overall goals of programs Synchronize reporting period…
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With OCR raising the seriousness levels of all covered entities in the healthcare Eco-system, it’s important for providers as well as Independent Software vendors (ISVs) to comprehend the various requirements that HIPAA imposes. The write-up below touches upon these requirements from a software capability perspective. Technical safeguards focus on the technology that stores or processes…
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Data driven healthcare solutions is to be the way ahead for the healthcare industry. Gone are the days when personal experience and word of mouth were the drivers behind healthcare decisions. Today’s patient needs numbers to validate what you have to say, and these numbers should be made available to them to make an informed…
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For the first time, many Americans are comparing and analyzing healthcare plans before buying one most suited to them. This is a huge change from how health plans were looked at earlier in the system. But, many of the first time insurance buyers are not health literate, which makes it difficult for them to understand…
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Researchers at University of Washington Tacoma have developed a machine-learning predictive analytics tool that forecasts with 82 percent accuracy the probability a patient will be readmitted within 30 days. In 2011, the federal government estimated that 30-day Medicare readmissions for all causes cost a whopping $26 billion annually, with $17 billion being attributed to avoidable…
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Amongst all the legislative activities, we still have October 1, 2015, as the date set for now as the deadline for ICD-10 code set switch-over. The Centers for Medicare & Medicaid Services announced last Monday that it would work with the American Medical Association (AMA) to ease the transition to ICD-10. For the first 12…
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March 8 – 14 was the patient safety awareness week, and as we at Nalashaa look deeper into our goal – accountable healthcare; we will be understanding Patient Safety Reporting in this post. Patient safety event reporting is one of the quality improvement requirements as mandated by the Affordable Care Act (ACA). At a Senate…
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Quality Oncology Practice Initiative (QOPI) is a program by the American Society of Clinical Oncology (ASCO) exclusively for outpatient chemotherapy clinics and practices, to work as a tool to measure performance and target improvements. In 2012, the number of registered QOPI participants was 200, spread across 42 states. In a period of 2 years, the…
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As discussed in previous post, PQRS reporting can be done using various methods: Claims-based Registry-based Qualified Electronic Health Record (EHR) Qualified Clinical Data Registry (QCDR) Group Practice Reporting Option (GPRO) PQRS Claim-based reporting The eligible professional must satisfactorily report on 50% of eligible instance for individual measure or 20 patients when reporting a measure group…
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PQRS is an abbreviation for Physician Quality Reporting System formerly known as the Physician Quality Reporting Initiative (PQRI). It is a reporting program that uses a combination of incentive payments and negative payment adjustments to promote reporting of quality information by eligible professionals (EPs). Payment Adjustments The program provides an incentive payment to practices with…
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ICD-10 has always been linked to billing, and this is one of the biggest areas, no doubt. But, the data collected via ICD-10 coding practices will find uses in a much wider arena. Moreover, these can be seen as the added benefits of having a thoroughly tested, and well – implemented ICD-10 coding system. Apart…
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Urgent care clinics or minor emergency setups are springing up all over riding on the need for quick medical assistance and owing to the waiting periods at regular hospitals. One of the main difference between these clinics and regular hospitals is these clinics do not take Medicaid, and hence are not required to attend to…
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The healthcare industry is undergoing a significant change with connected health being the way ahead. To create effective connections, we need to ensure a network architecture which will help in serving the needs of all those involved, from care givers to lab technicians to patients. Blue button initiative is a step in patient empowerment, allowing…
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