In the News
Stories and trends changing the healthcare landscape
Roadmap to Harnessing Value via Telehealth
Telehealth initiatives overall have shown potential to complement mainstream healthcare delivery at a lower cost and positive contribution to quality and outcomes (right care, right time).
Telehealth Integration into Care Delivery Post COVID-19
The COVID-19 pandemic has changed the way people interact with each other, turning to video and other forms of social media to stay connected. This embrace of virtual technology has extended to medical care and has paved the way for what may very well result in permanent changes in the how health care is utilized and reimbursed.
Navigating COVID-19 in the Healthcare Industry
We can all agree COVID-19 brought about a seismic shift in the delivery of healthcare in 2020. This article reflects on services shifts, challenges those shifts create and approaches for providers and payers to anticipate and navigate the initiatives.
CMS cancels two mandatory pay models and scales back a third
CMS is planning to reduce mandatory bundles based on results, provider feedback and “minimum” utilization considerations. Some programs will be cancelled, some will not launch in 2018 and one is being scaled back.
At the same time, we are helping our clients achieve great success building population health risk based management solutions. Let us help you identify your opportunities to improve outcomes and reduce the cost of healthcare.
http://www.modernhealthcare.com/article/20170815/…/170819935
Reducing Post Acute Costs for Mandatory CMS Joint Replacement Bundle
“Looking for ways to reduce your post acute costs for the Mandatory CMS Joint replacement bundle? New products are entering the market that allow providers to gauge progress without onsite visits…in surprising ways. Microsoft Kinect shifts from gauging your dance moves to measuring your gait and recovery from hip or knee replacement. In addition, tracking and providing on demand rehabilitation therapy programs with instant feedback. Tell us what you think!Read More.
Reimbursement for telehealth 40 percent less than for non-telehealth care
Reimbursement for telehealth services is much lower than non-telehealth care, according to a recent policy CMS Final Rule on Overpayments
Medicare Advantage Plans, need to update your strategy? Provider responsibilities and look back periods are reduced in the CMS final rule for overpayments. See more information:
The Centers for Medicare & Medicaid Services has issued a final rule regarding the legal requirements providers most follow if they are overpaid.
Medicare contractors overpaid $35.8 million for outpatient drugs
Medicare uncovers claims overpayments due to incorrect units of service and provider coding errors. CMS states Medicare contractors should collect their overpayments – how many outpatient overpayments are overlooked? Most focus on inpatient only. We can help!See More
New Ideas for Population Health Analytics Using Persona-Based Model
Some Health Plans are charting new territory in population health management: Member centric clinical persona. In the traditional disease/condition categorization, many members were in separate and unconnected programs. The nine clinical personas are: healthy kids, healthy adults, acute kids and adults, ADD High-Cost/Rx, Serious Mental Illness/Substance Abuse/Other At-Risk, Uncoordinated Care, Chronic Coordinated, Complex Managed and Extreme Complex. We find the approach compelling. Read More.
ICD-10 “More Specific” Diagnosis/ Symptom/ Injury Codes
Which “more specific” diagnosis/symptom/injury code is your favorite with the release of ICD-10 in October?
At Well Solutions Group, we picked “Pecked by a Chicken”, but “Bitten by a Cow” was a close second. Read More
