Health Plans Need Your Records: Know What ’s Driving Requests and How to Be Prepared
The following is a guest blog post by Craig Mercure, Chief Operating Officer of Payer Solutions at CIOX Health.
Audits. Reviews. HEDIS. Stars Ratings. No matter what, health plan record requests are growing by leaps and bounds each year. And the stakes are high for health plans to ensure they receive medical records in a timely way. What we also know – the large volume of requests and submission deadlines can put a drain on provider resources.
High volumes of medical record requests make it more important than ever for providers and health plans to work cooperatively and collaboratively. Here’s some helpful background...
Source: EMR and HIPAA - July 26, 2016 Category: Information Technology Authors: Guest Blogger Tags: Health Information Governance Healthcare HealthCare IT HIM CIOX Craig Mercure HEDIS Medicare Audits Medicare Risk Adjustment Source Type: blogs
People Post: Staff And Board Changes At Foundations; Job Opening: Foundation President
In June, Becky Hayes Boober left the Maine Health Access Foundation, where she was a senior program officer. She is now vice president of community impact at the Maine Community Foundation (MaineCF) and is working out of its Ellsworth office. She told me in an e-mail, “As part of our strategic planning, we are exploring goals related to health, such as opioid addictions and aging.” MaineCF is refining its new strategic plan, so more information will be forthcoming. Her new boss is Steve Rowe, former president of the Endowment for Health, which is in New Hampshire.
I missed it! Nicole Collins Bronzan joined the staff of...
Source: Health Affairs Blog - July 22, 2016 Category: Health Management Authors: Lee-Lee Prina Tags: GrantWatch Long-term Services and Supports Public Health adolescents Aging Behavioral Health California California Health Care Foundation Centers for Disease Control and Prevention Climate Change culture of health Health Philanthropy Source Type: blogs
FUD Part II: The Return of Fear, Uncertainty and Doubt
By JOHN HALAMKA
A Time of Uncertainty …
The upcoming presidential election has everyone spooked – what if Donald Trump is actually elected? What will the transition of administrations, regardless of who is elected mean to healthcare and existing healthcare IT regulations? Will our strategic plans and priorities need to change?
I’ve spoken to many people in government, industry and academia over the past month about the rapid pace of change stakeholders are feeling right now. Here are a few of their observations:
1. In the next year or two there will continue to be consolidation in the healthcar...
Source: The Health Care Blog - June 13, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized John Halamka Source Type: blogs
Evolving Hospital Community Benefit Could Be The Next Big Development In Health Philanthropy
“Hospital community benefit”: Remind me, what Is That again?
In our experience, when colleagues in health philanthropy hear the phrase “hospital community benefit,” their eyes begin to glaze over. We don’t blame them. It’s a unique and changing corner of the health philanthropy world, manifesting itself in different ways according to states’ varying regulations and differing organizational goals. Unless they’ve worked alongside a hospital on a community health initiative, grantmakers may not be aware of the opportunities in this field.
Nonprofit hospitals, in order to maintain their tax-exempt (or ̶...
Source: Health Affairs Blog - June 8, 2016 Category: Health Management Authors: Matthew Ingram, Allison Wolpoff and Jen Lewis Tags: Equity and Disparities Featured GrantWatch Hospitals Population Health ACA Affordable Care Act California Community Health Needs Assessment Consumers Counties data Health Law Health Philanthropy Health Reform Hospital communi Source Type: blogs
A Time of Uncertainty
The upcoming presidential election has everyone spooked - what if Donald Trump is actually elected? What will the transition of administrations, regardless of who is elected mean to healthcare and existing healthcare IT regulations? Will our strategic plans and priorities need to change?I’ve spoken to many people in government, industry and academia over the past month about the rapid pace of change stakeholders are feeling right now. Here are a few of their observations:1. In the next year or two there will continue to be consolidation in the healthcare IT industry. &n...
Source: Life as a Healthcare CIO - June 8, 2016 Category: Information Technology Source Type: blogs
Long-Time Scientific Review Chief Helen Sunshine Retires
Helen Sunshine, who led the NIGMS Office of Scientific Review (OSR) for the last 27 years, retired in April. Throughout her career, she worked tirelessly to uphold the highest standards of peer review.
Helen earned a Ph.D. in chemistry at Columbia University and joined the NIH intramural program in 1976, working first as a postdoctoral fellow and then as a senior research scientist in the Laboratory of Chemical Physics, headed by William Eaton.
In 1981, Helen became a scientific review officer (SRO) in OSR and was appointed by then-NIGMS Director Ruth L. Kirschstein to be its chief in 1989. During her career in OSR...
Source: NIGMS Feedback Loop Blog - National Institute of General Medical Sciences - May 17, 2016 Category: Biomedical Science Authors: Dr. Peggy Weidman Tags: News Source Type: blogs
Quality is another word for absolute control
Like an anthem, a holy grail, the word appears in every journal, every proposal, and every health strategic plan.
“Quality.”
We say, read and hear it so often we are developing quality fatigue. Like iterative hackneyed phrases such as “out-of-the-box”, “deep-dive” and perhaps even “personalized medicine,” quality has begun to feel like water torture and risks being deprived of flavor or meaning. However, do not so fooled or bludgeoned that you lose focus. Quality is another word for absolute control and power.
For too long, quality meant, “work hard, do a good job, care about the patient.” Every p...
Source: Kevin, M.D. - Medical Weblog - May 2, 2016 Category: Journals (General) Authors: James C. Salwitz, MD Tags: Physician Primary care Source Type: blogs
Office of National Coordinator Seeks Input on MACRA Interoperability
The Office of the National Coordinator for Health IT (ONC) released a new request for information (RFI) in which they are seeking the public's thoughts on how to measure interoperability. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) sets an objective to achieve the widespread exchange of health information through the use of interoperable certified electronic health records and directs the Department of Health and Human Services (HHS) to establish metrics in consultation with the health IT community and to see if that objective has been met. The public comment period closes on June 3, 2016. Comments can...
Source: Policy and Medicine - April 24, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
How Things Get Done In Washington: Insights From 23 Former CMS Leaders
If you like the series House of Cards, or perhaps you simply want a better understanding of how things get done in Washington D.C., you may want to check out a new resource from the National Academy of Social Insurance (NASI). Insights from the Top: An Oral History of Medicare and Medicaid is a series of 23 individual interviews with former administrators and acting administrators of the Centers for Medicare & Medicaid Services (CMS) and its predecessor, the Health Care Financing Administration (HCFA). NASI conducted the project as part of its celebration of the 50th anniversary of Medicare and Medicaid.
Particularly n...
Source: Health Affairs Blog - April 20, 2016 Category: Health Management Authors: Timothy Trysla Tags: Featured Health Professionals Medicaid and CHIP Medicare Organization and Delivery ACA CMS Democrats HCFA national academy of social insurance Politics Republicans Source Type: blogs
Meet the new NCCIH five year strategic plan, same as the old NCCAM five year strategic plan
It’s no secret that I’m not particularly fond of the National Center for Complementary and Integrative Health (NCCIH). Formerly known as the National Center for Complementary and Alternative Medicine (NCCAM) and before that the Office of Alternative Medicine, NCCIH has been the foremost government agency funding research into quackery and the “integration” of quackery into… (Source: Respectful Insolence)
Source: Respectful Insolence - April 11, 2016 Category: Surgery Authors: Orac Tags: Complementary and alternative medicine Politics Quackery Calvin and Hobbes Chocolate Frosted Sugar Bombs integrative medicine Josephine Briggs National Center for Complementary and Alternative Medicine National Center for Complementary and Source Type: blogs
The importance of a positive culture
This year marks 33 years of administrative positions in academic medicine. When I first started, I suspect I made many major mistakes. I learned through the time tested school of hard knocks. As I reflect on my own career, and those whom I have observed, I have come to believe the famous saying, “Culture eats strategy for breakfast“.
Look at ward attending physicians. The same attendings have “good teams” every time they attend. Their teams get the work done and thrive. The learners learn and progress. The same IM attendings have a greater percentage of students choose internal medicin...
Source: DB's Medical Rants - March 22, 2016 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Application and Funding Trends
The Consolidated Appropriations Act, 2016 , provides funding for the Federal Government through September 30. NIGMS has a Fiscal Year 2016 appropriation of $2.512 billion, which is $140 million, or 5.9%, higher than it was in Fiscal Year 2015. With this opportunity to expand NIGMS support for fundamental biomedical research comes a responsibility to make carefully considered investments with taxpayer funds.
Application Trends
One of the most commonly cited metrics when discussing grants is success rate, calculated as the number of applications funded divided by the number of applications received. As shown in...
Source: NIGMS Feedback Loop Blog - National Institute of General Medical Sciences - March 16, 2016 Category: Biomedical Science Authors: Monique Hall Tags: Budget Director’s Messages Funding Trends Source Type: blogs
New NIGMS Initiatives for Supporting Technology Development
The January 2016 Advisory Council meeting presentation on the initiatives begins at 1:14:43.
We would like to tell you about two new technology development initiatives recently approved by our Advisory Council. These programs are part of an ongoing effort that we’ve previously described to facilitate early stage, investigator-initiated work to create or improve tools for biomedical research.
Developing and providing access to technologies that enable biomedical research is a high priority for NIGMS, as expressed in our 2015 strategic plan. Historically, support for technology development has generally been co...
Source: NIGMS Feedback Loop Blog - National Institute of General Medical Sciences - March 16, 2016 Category: Biomedical Science Authors: Monique Hall Tags: Concept Clearances Source Type: blogs
Measures That Matter — But To Whom?
The health care and health policy communities are increasingly calling for “measures that matter.” Journal articles and policy reports have highlighted the proliferation of performance measures, and many conferences have focused on reducing the number of metrics to a small set. Overall, there are strong desires to rationalize the entire measurement approach, with leaders like Don Berwick advocating for an immediate reduction in measurement (perhaps by 50 percent).
One notable effort is the CMS-AHIP Core Quality Measures Collaborative, which seeks to align measures across public and private payers. The Collaborative, su...
Source: Health Affairs Blog - March 10, 2016 Category: Health Management Authors: Bruce Siegel, Christine Cassel and Robert Saunders Tags: Equity and Disparities Featured Health Professionals Hospitals Public Health Quality National Quality Forum quality measures Vital Signs Source Type: blogs
HIMSS16 Preview
It’s back to Las Vegas for HIMSS16 in a bit more than a week, which begs the question, what’s going to be theme of this year’s show? There’s typically very little data to apply to questions like that, until now.
Drew Ivan, Healthcare Solutions Strategist with Orion Health, wrote a post on LinkedIn on HIMSS16 trends – with data! There’s a great diagram that compares the number of presentations under educational session categories have changed between 2015 and 2016. As an example, here are the top 5:
Care Coordination and Population Health – up substantially over last year
Proces...
Source: Medical Connectivity Consulting - February 18, 2016 Category: Information Technology Authors: Tim Gee Tags: Events Source Type: blogs
