Inside Angle

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Tag: CMS

Red Flag: OIG chart reviews of Medicare Advantage records raise concerns. Billions misspent?

February 14th, 2020 / By Barbara Aubry, RN

Audits of Hierarchical Condition Categories (HCCs) have been performed for years as a way for Part C vendors (Medicare Advantage Organizations) to identify and support patients with complex needs. Higher […]

2019 novel coronavirus

February 3rd, 2020 / By Audrey Howard

I know we have all been following the news reports about the outbreak of a novel coronavirus (COVID-19). The World Health Organization has declared it a Public Health Emergency of […]

First do no harm part 2: How can quality efforts harm patients?

January 15th, 2020 / By Cheryl Manchenton, RN

As I noted on my previous blog, the Hippocratic Oath has been in existence since anywhere from 200-500 AD and is still relevant today. I discussed how a proposed eCQM […]

A look back at popular blogs of 2019

December 18th, 2019

A big thank you to all Inside Angle readers! As we look ahead to 2020, we invite you to revisit some of our most popular blogs of 2019: “The Iron […]

First do no harm: Can eCQMs hurt patients?

December 16th, 2019 / By Cheryl Manchenton, RN

The Hippocratic Oath has been in existence since anywhere from 200-500 AD. One translation (which has been modified in a version with which we are more familiar) states: “I will […]

CMS: Hospital price transparency final rule update

December 9th, 2019 / By Barbara Aubry, RN

On December 3, I attended the CMS call on the final rule for hospital price transparency requirements. On December 4, I read an article in the New York Times stating […]

Does Medicare’s value-based purchasing model really create value in healthcare delivery?

December 2nd, 2019 / By Samuel Young, MD

Value-based reimbursement is the soup du jour in the medical industry these days. How value is defined, however, can vary depending on one’s perspective. Most experts in the field agree […]

Strategy weaving: Using HCCs, MACRA and readmission reduction requirements to strategize performance improvement

November 20th, 2019 / By Michael Malohifo’ou, RN, MBA

Far too often, healthcare organizations treat planning and execution as two separate processes which are intended to achieve a larger goal. Leadership makes plans and departments and workers are told […]

Article: Billing and coding: Compliant coding and documentation for physician assistants

With Kelly Long, CPC

Physician assistants are reimbursed under strict guidelines established by Medicare, Medicaid, TRICARE, and commercial payers, making it critical that coding and billing of PA services is accurate, complete, and compliant. […]

CMS proposed updates to the Stark Law: Comment now

November 8th, 2019 / By Barbara Aubry, RN

While reading a recent CMS release regarding proposed updates to the Stark Law, I was reminded that it was first released in 1998. With value-based reimbursement, relationships between providers has […]

The changing seasons of quality: The new IQR measures part 2

November 4th, 2019 / By Cheryl Manchenton, RN

As I noted in my previous blog on the changes to the IQR program, fall brings joy to some and sadness to others. With the fall comes changes to the […]

The changing seasons of quality: The new IQR measures, part 1

October 28th, 2019 / By Cheryl Manchenton, RN

“A time to weep and a time to laugh; a time to mourn, and a time to dance” Ecclesiastes 3:4 Fall brings joy to some and sadness to others. I […]