May 19, 2020 | Uncategorized
Have you started preparing for the new 2021 E/M changes? It is never too early as much of healthcare is already changing. Read below for more information on what has prompted the changes in the healthcare system.nnWith all that 2020 has already brought to the table and the changes it has prompted in the healthcare industry, it is important that each of us not lose track of what the future holds.nnAlthough the final rule is not scheduled to be released until November 2020, it is important that practice managers start talking, teaching, and planning now with their teams. These changes have been focused on how providers document and report E/M encounters and have been several years in the making.nnAMA’s director of editorial and regulatory services Zach Hochstetler said in a recent webinar, “We are encouraging everyone to adopt these changes now”. In addition to this, it was announced that AMA has plans to release educational and training material as well as web-based tools to assist in the transition.nnStart training your providers now to recognize the appropriate medical decision making, or MDM, level, and then driving the rest of the key elements to match this. As the new guidelines allow providers to select their level of service based on MDM or time, this will become the most important element of the encounter documentation.
May 5, 2020 | Uncategorized
Since the COVID-19 outbreak, there are certain aspects of healthcare that will never be the same. Below, CEOs of some of the biggest healthcare providers in the United States have provided their take on what they believe will never be the same in healthcare. Read the article below to find out more on their perspectives. nnThe healthcare industry’s vocabulary has avoided the word “never.” The COVID-19 pandemic has tossed aside squishy, non-committal words like “iteration” and “evolution” and replaced them with “permanently” and “over.” Healthcare leaders are facing a very different healthcare world because of COVID-19.nnHealthLeaders Exchange program director and editor Jim Molpus reached out to 17 trusted advisors to get their perspective on what will never be the same again in healthcare. The responses were passionate, diverse, and hopeful:nnVERY LITTLE WILL BE THE SAME AGAIN IN HEALTHCARE.nnI expect very little will be the same as it used to be after this pandemic is behind us. This crisis is altering—perhaps permanently—how and where providers interact with their patients and with each other, how providers approach their work, and how health systems respond individually and collectively under intense pressures. Stay-at-home and physical-distancing directives have thrust new telemedicine into the spotlight for giving patients more choices to be seen when and where they want to be seen.nnA nice-to-have service before the pandemic, virtual office visit capability is now elevated to a must-have care delivery option. This will fuel a burst of competition as providers race with urgency to expand virtual care access. I am hopeful the lessons learned during COVID-19 will drive innovation that transforms care quality, safety, efficiency, preparedness, and patient satisfaction. I am often asked if my organization, and our nation, will weather this healthcare crisis. The answer is yes, and we will be stronger. But we also understand that overcoming this threat means being changed by the experience.nnGary S. Kaplan, MDnChairman and CEOnVirginia Mason Health SystemnSeattle, WAnnTHE STATUS QUO WILL NEVER BE THE SAME AGAIN IN HEALTHCARE.nnExecutives are likely to encourage employees to work from home. Significant savings can be realized by eliminating expensive commercial space and allowing employees to work remotely. Remote workers are happier and more engaged without brutal commutes. As appropriate, employees can now watch over their young children, take care of older or sick family members, attend important events, and enjoy a higher quality of life. It will be hard to bring everyone back from home once they have demonstrated improved productivity, wellness, happiness, and its ultimate impact on the bottom line.nnSarah RichardsonnVP Change Leadership, ITnOptumnLos Angeles, CAnnPROCESSES WILL NEVER BE THE SAME AGAIN IN HEALTHCARE.nnHospital operations will never rely so heavily on human processes again in the future. The days of relying on huge teams of humans to accomplish routine mission-critical processes are over. Health systems will hire AI workers to take on critical “keep the lights on” processes and shift their human workforce to focus on the quality of care delivery.nnSean LanenCEOnOlivenColumbus, OHnnDAY-TO-DAY HOSPITAL OPERATIONS WILL NEVER BE THE SAME AGAIN IN HEALTHCARE.nnFrom social distancing guidelines to how we greet one another, the way we manage the day-to-day operations of healthcare will never be the same. Small conference rooms will make people uncomfortable; handshakes will be frowned upon, and face-to-face meetings will be replaced by Zoom and GOTOMEETING. Losing the human connection will be a concern that everyone will think about … but I am confident that new ways of communication and operations will evolve to ensure that human contact is not lost.nnBeverly Bokovitz, DNP, RN, NEA-BCnVice President & Chief Nurse ExecutivenUC HealthnCincinnati, OHnnHEALTHCARE SPENDING WILL NEVER BE THE SAME AGAIN IN HEALTHCARE.nnThe U.S. will emerge from this pandemic with WWII levels of debt. The trillions in debt will require healthcare spending to be on a different trajectory. There are a few levers of change that can be pulled:n
n
- More preventive care, but that does not appear to be solving the cost problem so far.
n
- How we behave: what we eat, use of drugs/alcohol, etc.
n
- Deliver less care: Other countries invest less in certain services than the U.S., such as knee/hip implants, spine fusions, cardiac caths, proton beams, etc.
n
- Deliver healthcare like we deliver other services, with as much globalization and technology as possible, and the human touch has been ratioed to those paying a premium.
n
nNeil CarpenternVice President of Strategic PlanningnArray AdvisorsnWashington, D.C.nnOUR COLLECTIVE SENSE OF HEALTH AND SECURITY WILL NEVER BE THE SAME AGAIN IN HEALTHCARE.nnFor most of us, health, or the lack thereof, is personal. We suffer alone with heart disease, cancer, or possibly dementia. COVID-19 is different. It touches the national psyche. Whether young or old, white or black, each of us and our family is at risk. COVID-19 presents a unique opportunity to rethink what we want from our healthcare system. As Americans, we tend to focus on the new and novel, a cure for cancer or some other esoteric disease, while ignoring ancient foes like bacteria and viruses, mundane public health concerns. What are we willing to give up in order to get a safer future for all of us?nnAlan Pitt, MDnProfessornBarrow Neurological InstitutenPhoenix, AZnnHEALTH SYSTEMS’ RELATIONSHIPS WILL NEVER BE THE SAME AGAIN IN HEALTHCARE.nnWith their team members (Did we keep you safe? Were we transparent and selfless?); with their communities (Could you count on us? Were we prepared?); with their patients (Did we show compassion even under extreme duress? Did we let a loved one die alone?); with technology (Had we already invested in reliable platforms for telemedicine, robotic process automation, virtual care, and more? Were we playing catchup, with too little too late?). Every crisis creates challenges and opportunities with relationships. A chance to make bonds stronger and more permanent, or the loss of what once was and what might have been. The COVID-19 crisis is an extreme example of this reality.nnRonald Paulus, MDnFormer CEOnMission HealthnAsheville, NCnnTHE STATUS QUO WILL NEVER BE THE SAME AGAIN IN HEALTHCARE.nnSociety’s acceptance of status-quo healthcare as acceptable is over. We now know that a suboptimal public health and healthcare system can bring our entire world to a complete stop, result in a needless number of deaths, and put our wonderful healthcare workers in unnecessary danger. Our collective demand for prioritized investment, higher standards, and embrace of innovation will become the norm. Leaders will be on notice.nnMarcus WhitneynCEO & Co-FoundernHealth FurthernNashville, TNnnHOSPITALS WILL NEVER BE THE SAME AGAIN IN HEALTHCARE.nnEmergency preparedness will be a differentiator. One in four will face insolvency unless a federal bailout keeps them afloat. Telehealth will be mainstreamed. Workforce safety will be a testy issue. Consolidation will accelerate. Insurer’s leverage, uncompensated care, and physician disaffection will heighten. And capital portfolios will be adjusted to rationalize investments more strategically.nnPaul KeckleynThe Keckley ReportnNashville, TNnnTHE HOSPITAL ADMINISTRATOR-CLINICIAN RELATIONSHIP WILL NEVER BE THE SAME AGAIN IN HEALTHCARE. nnAs someone with friends on both sides of the aisle, I believe COVID-19 has strained the relationship to the point where clinical leadership will now demand greater accountability over hospital operations and emergency preparedness. There has always been a fascinating dynamic between business-minded hospital strategy versus day-to-day patient care. However, during times of extreme duress, the clinicians on the COVID-19 front lines have disproportionately borne the brunt of the pandemic. I think there will be some tough but necessary conversations about emergency supply storage, hazard pay, sick pay, or relocation benefits to avoid family contamination moving forward.nnAndy MychkovskynHealthcare Strategy Consultant and CreatornHealthcarepizza.comnWashington, D.C.nnSPEED TO INNOVATE MUST NEVER BE THE SAME AGAIN IN HEALTHCARE.nnThis crisis has revealed the unquestionable need that we commit to human experience at healthcare’s core for those we serve and those who serve as human beings caring for human beings. It too has shown us it does not and must not take us months or years to innovate to ensure the best in care. Innovations in process, protocols, and products should no longer be stuck in extended analysis and review. We can identify, analyze, and act to address opportunities quickly and must do so in a new healthcare world that will require a delicate blend of agility and compassion.nnJason WolfnCEOnThe Beryl InstitutenNashville, TNnnFACE-TO-FACE PHYSICIAN VISITS WILL NEVER BE THE SAME AGAIN IN HEALTHCARE.nnIn the face of this pandemic, we condensed a planned 18-month rollout of our telemedicine program to just nine days. We went from zero telemedicine visits in October to a handful of doctors being trained and us all being very excited when the first video visit was conducted in November, to where we are now: nearly 3,000 telemedicine visits a day, about half of which are video visits. These are conducted by more than 800 providers across primary care and specialty care lines. This is working well for all involved. So, I don’t think we will ever go back to the old way of seeing and treating patients.nnChris Van GordernCEOnScripps HealthnSan Diego, CAnnBUSINESS STRATEGY WILL NEVER BE THE SAME AGAIN IN HEALTHCARE.nnHealthcare organizations will think about business strategy in terms of anticipating disruption versus reacting to disruption. Leaders will be thinking through their strategies as a collection of unique scenarios to be more agile, bold, and forward-thinking. Two important elements will become the foundation of many healthcare strategies—people and partnerships. Organizations that put their people at the center of strategy will engender trust, loyalty, and gain a competitive advantage. Partnerships with traditional and nontraditional healthcare organizations will be the key amplifier for growth.nnJhaymee Tynan, FACHEnAssistant Vice President, IntegrationnAtrium HealthnCharlotte, NCnnPUBLIC HEALTH WILL NEVER BE THE SAME AGAIN IN HEALTHCARE.nnMost healthcare leaders and practitioners have a belief system grounded in science and rationality and use these when committing to improving the system, at least within their vision of what is possible. It is too easy to forget that the political system which regulates public health and funds local health departments does not share or assume this thought process, and oftentimes unqualified individuals are elected to oversee and fund public health. We cannot afford any longer to assume the government is doing its job to ensure adequate public health. Perhaps now the time is right for combined political pressure from the AHA, et al., to form public interest coalitions to lobby for change at all levels of government.nnMark Herzog, FACHEnConsultant and CEO, RetirednHoly Family MemorialnManitowoc, WInnSUPPLY CHAINS FOR PHARMACEUTICALS AND ESSENTIAL MEDICAL EQUIPMENT WILL NEVER BE THE SAME AGAIN IN HEALTHCARE.nnThe COVID-19 pandemic has shown us critical deficiencies in the supply chain of essential drugs, even as basic as medications for sedation. Even with certain drugs formulated within the U.S., the APIs (Active Pharmaceutical Ingredients) are sourced from foreign countries. Most of the generic drugs in the U.S. are also sourced from Asian countries. Cost alone cannot dictate the supply chain—the proximity and accessibility will be factors that will have to be dealt with. This scenario holds true not only for pharmaceuticals, but also for medical devices and medical gear for clinicians. The next pandemic which hits us globally could very well be more potent, both in terms of its mortality and infection rate, and plans to rectify the supply chain deficiencies have to be addressed immediately.nnJay SrininChief StrategistnSCS VenturesnPittsburgh, PAnnBEING TAKEN FOR GRANTED WILL NEVER BE THE SAME AGAIN IN HEALTHCARE.nnThe assumption that while the world turns, few consider healthcare until they are in need. In the future, our world will recognize the significant impact that healthcare can have on ALL areas of our lives. Into the future, we will become much more important and relevant.nnBritt BerrettnProgram DirectornThe University of Texas at DallasnDallas, TXnnTELEHEALTH WILL NEVER BE THE SAME AGAIN IN HEALTHCARE.nnTelehealth’s rapid scale-up has been critical in the public health response to COVID-19. Now, telehealth has reached its tipping point, with consumers unlikely to revert to the previous reality once we are beyond the pandemic. Looking post-pandemic, telehealth will be critical to addressing access to care issues and helping mitigate the clinician shortage. For the former, providers must figure out sustainable pricing models that hold clinicians and patients accountable. For the latter, they will need to determine which clinicians should deliver what types of care services via telehealth and which ones should be elevated to higher levels of practice elsewhere on the continuum.nnSteven ShillnPartner and National LeadernBDO Center for Healthcare Excellence & InnovationnOrange County, CAnnOriginal article published on healthleadersmedia.com
May 5, 2020 | Uncategorized
During these times of social distancing, isolation, businesses being shut down, and employees being laid off, it is hard for a lot of people to feel the same fulfillment they did just a few months ago and self-pity can set in quickly. nnPerhaps you believe in the theory that there is nothing better for self-pity than you go out and help others. Volunteering is one of those opportunities that can take so many different forms. And when we relate this specifically to your career, knowledge sharing can not only be beneficial to your co-workers, networking groups, or community, but also to yourself.nnKnowledge sharing in these times can be as simple as writing a short article, hosting a virtual networking event, spending some downtime working with a co-worker, or volunteering to talk on a topic to a group. And with virtual meetings, your fear of standing in front of a group and speaking just may improve by practicing talking to a webcam.nnClick here for more about knowledge sharing.
Apr 30, 2020 | Uncategorized
Many providers should start making preparations ahead of time for elective surgeries. Creating a prioritization model is highly recommended to determine the demand and constraints that they may encounter. Read the article below for more information on what you should do now to prepare for the elective surgery demand.nnSurgical patients are on hold, and providers have lost a valuable source of revenue to support their operations. Hospital strategists, in partnership with community surgeons, are already working to understand the financial impact. They must also now begin to create a purposeful plan for managing elective surgery demand after COVID-19.nnMuch is still unknown. But what is certain is that as regions emerge from the crisis, there will be a dramatic surge in demand for elective procedures. There is a short window right now in which our hospitals and health systems must take a data-driven approach to prioritize this pent-up demand. And develop a strategy for addressing it quickly and efficiently.nnHospital executives and surgeons must determine the demand forces that they must prioritize against:n
n
- Number of elective cases in the community per surgeon (inpatient or ambulatory)
n
- Patient condition and need for care
n
- Surgeon and case predictability by the length of the case and individual skill
n
- Revenue generation per case
n
- Length of time patient has been waiting for care
n
nCreating a prioritization model requires matching those demands to facility capacity constraints:n
n
- Inpatient beds available to care for post-surgical patients
n
- Availability of personal protective equipment (PPE), such as masks, gloves, and gowns
n
- Physician preference items (PPI), such as hip replacements, knee replacements and neurosurgical screws and plates
n
- Staffing availability and skill sets, especially in light of exhausting our staffs during the crisis
n
- Timing of COVID-19 patient number decline in the current wave
n
nOrganizations will have to rethink their traditional models in favor of a rapid-response mentality. You can’t resume a business-as-usual approach where hospitals try and fit the pent-up demand into their current scheduling operations. That won’t work, and it will lead to capacity constraints.nnCurrent levels of operational inefficiency, especially around traditional block schedule management, will get in the way of meeting both normal and pent-up demand. It doesn’t allow for the prioritization approach to succeed.nnIn particular, the need for a rapid post-COVID-19 response will require surgical suites to rethink their traditional individual surgeon block methodology. They’ll need to create usable free space and maximize the use of the entire operating room to meet the pent-up demand. The “rapid response” will need to include:n
n
- Boosting utilization to over 75% to allow more cases in their daily prime time. This means rethinking block management to create more capacity in the surgical suite prime-time hours.
n
- Moving less intensive procedures (such as many dental and endoscopy cases) to dedicated Procedure Rooms. This removes them from the daily caseload of the surgical suite.
n
- Expanding the hours of surgical suite availability each day well into the evening and possibly open to elective cases on weekends.
n
nExecuting this strategy will require immediate action. You’ll need to use available data from both the hospital and its affiliated surgeons to:n
n
- Understand community and hospital constraints
n
- Rethink operational processes
n
- Partner with community surgeons in ways most have never done
n
nOrganizations like Optum Advisory Services are ready to help in modeling, prioritizing, and planning for the return of elective cases. Understandably, hospital executives are focused on responding to the current crisis. But there’s little time left to create a strategy to accommodate pent-up elective surgery demand. And you’ll need to rescue revenue generation so that hospitals can continue to serve their patient communities long past the current pandemic.nnOriginal article published on healthleadersmedia.comnn
Apr 30, 2020 | Uncategorized
As the Risk Adjustment payment models become more and more commonplace, it is important that we not forget about this when coding during our current public health emergency (PHE). Read below to find out more about hierarchical condition categories.nnHierarchical condition categories, or HCC’s, are assigned to diagnosis codes and reflect an aggregated value that is assigned based on illness severity. When we talk about COVID-19 and diagnosis correct coding, we have a new U code for reporting however there is code specific guidance we also must consider. When we report code U07.1 [ COVID-19], important to remember codes B34.2 [Coronavirus infection, unspecified], B97.2- [Coronavirus as the cause of diseases classified elsewhere], J12.81 [Pneumonia due to SARS-associated coronavirus], or J80 [Acute respiratory distress syndrome]. All of these codes should be used to identify manifestations associated with their COVID-19 diagnosis. Of these, only J80 is currently assigned an HCC value.nnGuidance is changing by the day and sometimes by the hours so it is important to make sure you are staying up to date with all guidance from CMS, WHO, and private payers.nnClick here for Official Coding and Reporting Guidelines
Apr 21, 2020 | Uncategorized
The Federal Government has introduced various programs to make funds available to individuals and businesses during this Public Health Emergency (PHE). Currently, there are options available for providers and practices to receive funds through multiple programs, including the Coronavirus Aid, Relief, and Economic Security (CARES) Act and the CMS Accelerated and Advanced Payment Program. Here you will find a summary of these programs as well as a breakdown of how you may receive funds, what the funds are for, and the conditions for use. Click here to download the PDF of Specific Provider Programs.nnnnHelpful Links and Resourcesn
