The 2-midnight rule may get a little tweak if the proposals in CMS' 2016 OPPS proposed rule comes to fruition. The rule proposes that physicians now be granted a little more flexibility when it comes to ordering inpatient admissions, even when the stay is expected to be less than two midnights?provided of course that the stay is justifiable from a medical standpoint and the physician clearly documents his or her thinking on the case.
Starting a population health program can not only help organizations improve patient health, but can also help a hospital's bottom line by reducing readmissions and cutting down on costly emergency department visits. But many case managers may wonder what it takes to get a population health program off the ground.
Educating coders and clinical documentation improvement (CDI) specialists on CMS claims-based measures is essential in today's value-based payment environment. Empowered with an understanding of measure specifications and risk adjustment methodologies, a strong CDI program can effectively address opportunities to improve quality profiles and associated hospital revenue.
Ready or not, Phase 2 of OCR's HIPAA audit program is nearly ready to begin, and healthcare organizations and their business associates (BA) should be prepared to open their books to federal regulators.
There are a number of tools on the market to assist covered entities (CE) and business associates (BA) in addressing their compliance needs. Solutions range from large governance, risk, and compliance programs to tools that assist in the development of a compliance program. When it comes to ongoing compliance management, Ostendio's My Virtual Compliance Manager™ (MyVCM™) offers a solution that is more than just a tool for an occasional look at the compliance stance of an organization.
