Inside Angle

From 3M Health Information Systems

Tag: Medicare

Ten years after “The Cost Conundrum” – How much has changed?

May 3rd, 2019 / By Steve Delaronde

McAllen, Texas is a border town in the Rio Grande Valley with a metro population of 839,000. On May 25, 2009, Atul Gawande published The Cost Conundrum in which he […]

Modernization of LCD process and relocation of codes

February 1st, 2019 / By Divya Verma, RHIA

On October 3rd, 2018 Medicare announced significant changes to the Local Coverage Determination (LCD) process. As a result, a major change to the LCD format was also announced in Change […]

Webinar: Ready for 2019 value-based purchasing?

With Cheryl Manchenton, RN

The new year is upon us: Are you ready for the 2019 Value-Based Purchasing Program? Eric Sorenson and Cheryl Manchenton will help you get up to speed.

Infographic: Infections with the highest impact on Medicare HAC penalties

When it comes to reducing Hospital Associated Infections (HAIs), where should your organization focus its efforts?

Preview

New momentum to realize the opportunity of telehealth

April 4th, 2018 / By Katie Christensen

On February 9, a new telehealth bill was signed into law that expands coverage for accountable care organizations (ACOs), improves flexibility for telehealth use under Medicare Advantage plans, and allows […]

Solving the mismatch between poor quality scores and outstanding care

January 29th, 2018 / By Kristine Daynes

Recently, I reviewed the Medicare Hospital Value-Based Purchasing (VBP) scores for three hospitals recognized nationally for outstanding care and patient safety. They didn’t look good. The ratings for clinical outcomes […]

CMS: Low Volume Appeals Settlement Initiative

January 17th, 2018 / By Barbara Aubry, RN

I attended the January 9, 2018 CMS Medicare Learning Network conference call covering the logistics of the settlement process offered by CMS for providers with pending appeals. This impacts: “The […]

Article: The role of HCCs in a value-based payment system

With Donna Smith, RHIA, L. Gordon Moore, MD

L. Gordon Moore and Donna Smith discuss how appropriate documentation and coding of hierarchical condition categories (HCCs) can have a significant impact on payment in a value-based system.

Are Medicare readmission penalties working?

December 18th, 2017 / By Paul LaBrec

In 2012, the Centers for Medicare and Medicaid Services (CMS) began its Hospital Readmissions Reduction Program (HRRP).  The program, included in the Affordable Care Act, was designed to improve post-acute […]

Can the health insurance exchanges be stabilized? Yes, by giving insurers more options

October 11th, 2017 / By Richard Averill, MS, Richard Fuller, MS

Medicare beneficiaries are constantly bombarded with mail, emails and advertisements from insurers encouraging them to buy a Medicare supplemental insurance policy. It seems odd that there is such an aggressive […]

CMS: Updates to prohibition on billing dually eligible individuals enrolled in the QMB program

September 6th, 2017 / By Barbara Aubry, RN

Last fall, I wrote a blog on providers who continue to bill cost-sharing co-payments to “dually eligible” (Medicare/Medicaid) patients. This practice is not allowed; providers and suppliers are barred from […]

Global surgery visits: New requirements to bill Medicare

June 26th, 2017 / By Rebecca Caux-Harry

This month, Inside Angle blogger Rebecca Caux-Harry discusses E/M coding guidelines with Andee Andriole, 3M senior manager of outpatient consulting services. Andee: So, I guess we need to start thinking […]