Aug 8, 2019 | Uncategorized
New changes are coming regarding evaluation and management guidelines. Some of these new changes include updates on medical decision making and code selection. We will be seeing these much needed updates in 2021. Read the article below to get updated on all the other changes that are coming.nnIn an ongoing effort to reduce clinician burden, the “counting” of qualifiers in history and exam will soon be a thing of the past. Exciting changes are on the horizon for evaluation & management guidelines, including updates to how medical decision making (MDM) is determined. Although E/M codes will no longer be selected based on how much history or exam is documented, clinicians should still expect to document when the medically necessary pieces of work was done to fully address the patients presenting problem(s).nnStarting in 2021, code selection will be determined by the number/complexity of presenting problems, data reviewed and the risk of complications. Time will also be another method for appropriate E/M selection. With the new coding guidelines, clinicians will be able to count DAY OF face-to-face time AND non-face-to-face time they personally spend on a patients care. Reviewing tests, other records, ordering medications performance of medically necessary exam can all be used for time calculation.nnOffice visit codes will have new time ranges when the implementation takes place. Fine-tuning clinically relevant documentation, telling clear stories about patient encounters and getting better at time-based capture/reporting now will help prepare for these much needed changes we will be seeing just around the corner in 2021.
Aug 6, 2019 | Uncategorized
Welter Healthcare Partners has successfully completed yet another important project for the State of Colorado. We were asked by the Colorado State Innovation Model (SIM) to create a curriculum to help primary care practices better understand how to integrate behavioral health services into their commercial payer contracts such that these services will be reimbursed and as a result remain sustainable.nnThere are six chapters for this curriculum, made up of both workbooks and webinars to help guide you through the program. This content was developed and produced using funding from the Colorado State Innovation Model, a federally funded, Governor’s Office initiative. Click here to learn more.nnYou may follow this link to the Welter Healthcare Partners website where you can view the videos and workbooks for this curriculum and you can also check out our YouTube channel.
Aug 6, 2019 | Uncategorized
As difficult as it may be, embracing change is essential to growing as an individual, being a better employee and a better person than you were yesterday. Focusing on a positive perspective when faced with difficult challenges or changes can help us adapt when we are pushed out of our comfort zones. The following article focuses on this subject and includes great examples of situations that require adaptability and exercises to help you improve your acceptance to change.nn
Is This Me?nnThink about these statements, and choose A or B:n
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- A) I tend to think of change as bad. B) I tend to see change as an opportunity.
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- A) I dislike change. B) Some change can be worthwhile.
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- A) I feel uptight when plans change at home or work. B) I find changes in plans energizing.
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- A) I hate making adjustments in my routines. B) I make adjustments to routines easily.
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- A) I feel threatened when a challenge arises. B) I like a challenge.
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- A) I often get “locked in” to an idea or approach to solving a problem. B) I’m open to new information when solving a problem.
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nIf you find yourself agreeing with most of the A statements, you may be someone who is uncomfortable with change. If you find yourself agreeing with more of the B statements, you may be more able to adapt as changes demand.nnLooking at your own beliefs and judgments can be an important first step toward greater adaptability. If you are fixed in your thinking, you may struggle against change rather than turning it into an opportunity. Learning to sit with discomfort amidst uncertainty is something every human can benefit from.nnAn agile mindset is one that recognizes that adapting to change is the price of admission for living a meaningful life. Let’s face it, any time you try something new, you face uncertainty and there is risk involved. You never know exactly how things will turn out. For example, you may have to make a decision about whether to take a new job or stay where you are. There are no guarantees the job will be a good fit. If it is, great! You took the leap and it paid off. If the new job isn’t great–you chalk it up to learning. You are wiser, you gain new skills, new connections, and you’re able to translate that into a better decision next time. The bottom line: change is difficult, uncomfortable, and at times downright painful. Our ability to effectively handle the discomfort of change improves through experimentation and repetition.nnHere’s how rigidity, the opposite of adaptability, can show up at work: Imagine an executive who quickly shuts down an idea suggested by a team member for a more tech-based system of project management that could increase productivity. The executive may not realize this “shut-down” reflex has become an unconscious habit, triggered by any suggestion of change, which results in his automatically coming up with reasons the new idea won’t work, rather than why it might. Such a habit keeps things as they are and squelches innovation. This lack of adaptability keeps inefficient practices in place, and, maybe worse, sends a message not to question the status quo. Over time, this results in stagnation, reduced passion, and energy and weaker financial results.nnHowever, imagine if that executive had been more adaptable and asked the rest of the team how they feel about the new idea and whether it’s worth trying. If they express enthusiasm, the adaptable executive might give it a chance to see how it goes. If it works, progress is made. If it doesn’t, something useful could still be learned. There is acknowledgement that innovation and change carry emotional and financial outlays. And the emotional outlay can be lessened with an emotionally agile mindset.nnAdaptability is at the heart of innovation in any environment.nnPeople who demonstrate adaptability combine curiosity and problem solving skills to achieve their goals. Persistence leads them to try new behaviors or methods of getting things done. They are resourceful and creative, especially when budgets are tight. These key building blocks to adaptability–agility, persistence, and trying multiple strategies–are vital skills for success.nnIncreasingly, adaptability is a key differentiator of effective leadership in highly tumultuous industries, such as technology and finance. Leaders who show strong adaptability recognize that their industry is continually changing and are better able to evolve. They realize they can’t be stuck doing the same old thing over and over. They think creatively and take calculated risks.nnThere are numerous case studies of once-thriving companies whose leaders were unable to embrace change, such as Blockbuster, Sears, and Kodak. Alternatively, we all know companies that make phenomenal examples of adaptability, including Apple and Google, who created new products we didn’t even know we needed. They were attuned to shifting trends and feedback from customers.nnConsider current workplace norms: teams are no longer fixed and steady, they form and disassemble; work is increasingly meted out in short-term contracts. And leaders are attempting to prepare a workforce for jobs that don’t yet exist. It should not be surprising then that employers are putting a high priority on the skill of adaptability.nnBy staying adaptable and open-minded, you continue to reinvent yourself and experience significant growth along the way.nnKeep in mind, there are times when there’s a good reason not to change, like preserving quality standards or time-tested effective strategies. The trademark of an adaptable leader, however, is the ability to balance core values with responsiveness in the face of a changing world.nnTry this exercise for developing your adaptabilitynnThink of a change in either your personal or professional life you have recently experienced or are currently experiencing. How do you feel about the change? How are you responding to the change?nnHere are some examples of situations that require adaptability:nnWe are launching a new service line. I’m excited about the possibilities it creates, but a little nervous about whether we’ve thought of everything. I’m doing significant research to position myself as an expert.nnMy daughter just turned 12 and is suddenly becoming moody and withdrawn, spending lots of time in her room and not talking to me or her Dad. I’m scared something might be going on that she’s not telling us.nnNow, ask yourself a series of questions to help find a positive perspective on that change:n
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- What opportunities does this change represent?
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- What positive outcome could I find in this change?
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- What is outside of my control?
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- What is within my control?
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- What is the next (small) action I can take to move in a positive direction?
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- What is the best outcome that might result?
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nAvoiding change is impossible. Instead we can change our relationship to change. We can learn to turn toward what scares us, and in turn, we gradually adapt and grow amidst uncertainty and discomfort in life.nnOriginal article posted on keystepmedia.com
Jul 25, 2019 | Uncategorized
While it is said D.C. is slow to make progress on healthcare, individuals are stepping up with a plan noting that “The health of our nation is more important than any political party.” With changes and advancements in healthcare, the state of Colorado is implementing a new law that gives Colorado officials the authority necessary to pursue related federal waivers as needed. The rural areas of our state are experiencing a problem of unaffordable coverage due to insurer competition and limited/nonexistent coverage and state officials are ready to overcome these issues.nnUnited States of Care is a nonpartisan, 501(c)(3) organization dedicated to the goal of every American having access to quality and affordable healthcare.nn”The health of our nation is more important than any political party or partisan victory. United States of Care will chart a path toward a long-term healthcare solution, starting by checking allegiances at the door and putting the patient—our citizens—first.” Dr. Bill Frist, former U.S. Senate majority leader and current USofC board member, said these words at our founding just one year ago. We continue to live by them.nnWith Washington, D.C., slow to make progress on healthcare, we have looked to the laboratories of our democracy—the 50 state governments—to lead our nation and help us chart a path advancing healthcare for everyone. Recently, we have seen significant progress in state legislatures across the country. Acting as a resource, facilitator, convener and technical expert, USoC has connected with healthcare leaders, advocates and others in over 30 states and has formally engaged with partners in Connecticut, Minnesota and New Mexico to support advances in healthcare delivery—learning best practices to share with other states.nnThroughout America and across income groups, Americans say affording healthcare is their most important financial problem. The majority of Americans, across party lines, are concerned about surprise medical bills, prescription drug prices, and coverage for those with pre-existing conditions. This is why state leaders are responding to their constituents’ concerns and seeking policies to make our healthcare system work better for everyone.nnThis unifying feeling—that healthcare is out of reach and unaffordable to many even when one has insurance—eclipses political party and is moving state legislatures across the country to address it. Each state is different, however, and the way lawmakers fix issues—ranging from skyrocketing prescription drug costs to finding ways to make additional coverage choices available and protecting people from financial devastation due to surprise medical bills—is unique in every state.nnThe progress being made state-by-state is a promising march toward the ultimate goal of every single American having access to quality, affordable healthcare regardless of health status, social need or income. Our 2019 State Health Policy Progress analysis hows examples of meaningful progress in 14 states across the country.nnThese state successes are emerging from across the country and from all types of states.nn
nnColorado enacted bipartisan legislation directing two state agencies to develop a plan for creating a competitive state insurance plan by Nov. 15, 2019. This new law gives Colorado officials the authority necessary to pursue the federal waivers required to implement the plan. The main goal is to take on the problem of unaffordable coverage in regions of the state, overwhelmingly rural, where insurer competition and affordable coverage is limited or nonexistent.nnColorado also entered 2019 as one of six states with a “C” grade on enforcement of mental health parity. To remedy this, Colorado passed bipartisan legislation to step up requirements for mental health and physical health services to be covered equally. The legislation also increases much needed enforcement and oversight of mental health parity laws.nnMinnesota, the only state with legislative chambers controlled by opposite parties, showed that state leaders can come together across party lines to address pressing problems. Policymakers were faced with the expiration of the state’s provider tax, which helps pay for MinnesotaCare, Medicaid and other vital services that provide care to over 1.2 million Minnesotans.nnLeaders from both parties came together to maintain this crucial funding source and extend the state’s reinsurance program for an additional two years. In Minnesota, reinsurance has reduced premiums by 20% in the individual insurance market. The state also reached a consensus on laws to improve mental health access, lower prescription drug costs, expand access to telehealth, address the opioid crisis, and strengthen elder care protections.nnComplete and original article published on modernhealthcare.com.
Jul 25, 2019 | Uncategorized
As difficult as it may be, embracing change is essential to growing as an individual, being a better employee and a better person than you were yesterday. Focusing on a positive perspective when faced with difficult challenges or changes can help us adapt when we are pushed out of our comfort zones. The following article focuses on this subject and includes great examples of situations that require adaptability and excercises to help you improve your acceptance to change.nnScientists tell us the adaptive ability of any system is usually gauged by its response to disruptions or challenges. In the case of the human system, a.k.a. you and me, adaptive abilities mean you are a person who is flexible in handling change, juggling multiple demands, and navigating new situations with innovative ideas and approaches.nnIs This Me? nnThink about these statements, and choose A or B:n
n
- A) I tend to think of change as bad. B) I tend to see change as an opportunity.
n
- A) I dislike change. B) Some change can be worthwhile.
n
- A) I feel uptight when plans change at home or work. B) I find changes in plans energizing.
n
- A) I hate making adjustments in my routines. B) I make adjustments to routines easily.
n
- A) I feel threatened when a challenge arises. B) I like a challenge.
n
- A) I often get “locked in” to an idea or approach to solving a problem. B) I’m open to new information when solving a problem.
n
nIf you find yourself agreeing with most of the A statements, you may be someone who is uncomfortable with change. If you find yourself agreeing with more of the B statements, you may be more able to adapt as changes demand.nnLooking at your own beliefs and judgments can be an important first step toward greater adaptability. If you are fixed in your thinking, you may struggle against change rather than turning it into an opportunity. Learning to sit with discomfort amidst uncertainty is something every human can benefit from.n
An agile mindset is one that recognizes that adapting to change is the price of admission for living a meaningful life.
nLet’s face it, any time you try something new, you face uncertainty and there is risk involved. You never know exactly how things will turn out. For example, you may have to make a decision about whether to take a new job or stay where you are. There are no guarantees the job will be a good fit. If it is, great! You took the leap and it paid off. If the new job isn’t great–you chalk it up to learning. You are wiser, you gain new skills, new connections, and you’re able to translate that into a better decision next time. The bottom line: change is difficult, uncomfortable, and at times downright painful. Our ability to effectively handle the discomfort of change improves through experimentation and repetition.nnas become an unconscious habit, triggered by any suggestion of change, which results in his automatically coming up with reasons the new idea won’t work, rather than why it might. Such a habit keeps things as they are and squelches innovation. This lack of adaptability keeps inefficient practices in place, and, maybe worse, sends a message not to question the status quo. Over time, this results in stagnation, reduced passion, and energy and weaker financial results.nnHowever, imagine if that executive had been more adaptable and asked the rest of the team how they feel about the new idea and whether it’s worth trying. If they express enthusiasm, the adaptable executive might give it a chance to see how it goes. If it works, progress is made. If it doesn’t, something useful could still be learned. There is acknowledgement that innovation and change carry emotional and financial outlays. And the emotional outlay can be lessened with an emotionally agile mindset.nnAdaptability is at the heart of innovation in any environment.nnPeople who demonstrate adaptability combine curiosity and problem solving skills to achieve their goals. Persistence leads them to try new behaviors or methods of getting things done. They are resourceful and creative, especially when budgets are tight. These key building blocks to adaptability–agility, persistence, and trying multiple strategies–are vital skills for success.nnIncreasingly, adaptability is a key differentiator of effective leadership in highly tumultuous industries, such as technology and finance. Leaders who show strong adaptability recognize that their industry is continually changing and are better able to evolve. They realize they can’t be stuck doing the same old thing over and over. They think creatively and take calculated risks.nnThere are numerous case studies of once-thriving companies whose leaders were unable to embrace change, such as Blockbuster, Sears, and Kodak. Alternatively, we all know companies that make phenomenal examples of adaptability, including Apple and Google, who created new products we didn’t even know we needed. They were attuned to shifting trends and feedback from customers.nnConsider current workplace norms: teams are no longer fixed and steady, they form and disassemble; work is increasingly meted out in short-term contracts. And leaders are attempting to prepare a workforce for jobs that don’t yet exist. It should not be surprising then that employers are putting a high priority on the skill of adaptability.nnAdditional information and helpful tips can be found on original article published on keystepmedia.com.n
Jul 19, 2019 | Uncategorized
Health insurance premiums have been an ongoing topic of discussion for Colorado government leaders, medical professionals, insurance companies and patients. With continuous changes throughout the industry, the latest development includes the drop of health exchange premiums. Read the article below for more information recently released and the expectations to come.nnWestern Slope families could save nearly $9,000 a yearnnFor the first time since Colorado started its health insurance exchange, the prices people pay for coverage are expected to drop — by a statewide average of 18.2% — next year if the federal government approves a new state program called reinsurance.nnFor families on the Western Slope, who pay some of the highest insurance premiums in the country, the savings is expected to be nearly $9,000 a year. The Colorado Division of Insurance projects the average savings for Pueblo County at $6,696 annually and $3,369 for metro area residents.nn“I mean, that’s just transformational in terms of saving families money,” Gov. Jared Polis said at a press conference Tuesday.nnReinsurance is basically a pool of $260 million in state and federal money that Colorado plans to use in 2020 to help cover some of the most expensive medical bills among the 250,000 people in the state’s individual market. The idea is that this alleviates some of the burden on insurance providers, which in turn lower their premiums.nnMinnesota’s reinsurance program, for example, dropped its individual premiums by 11.3% and Alaska’s declined by 26%.nnColorado’s reinsurance program is still waiting on final approval from the federal government, but Colorado Insurance Commissioner Mike Conway said he’s all but certain that will happen this fall. Seven states already have federal waivers.nnThe final rates for 2020 health insurance premiums will be released in late September or October.nn“We’ve been working on this for years … ,” said Sen. Bob Rankin, R-Carbondale. “But my caution on this is this doesn’t do anything to really lower the cost of health care.”nnThe news that insurance premiums on the exchange could see a double-digit drop received praise from both the Colorado Hospital Association and Colorado Consumer Health Initiative.nn“We are pleased that the Insurance Commissioner is projecting a decrease in premiums on the individual market for 2020, as it reflects the many efforts by hospitals and providers to take ownership of their portion of the total cost of care,” said Steven Summer, president and chief executive officer of the hospital association, in a prepared statement.nnThe Consumer Health Initiative “expressed cautious optimism” at the expected drop in premiums while warning thatif the Affordable Care Act — also known as Obamacare — is struck down in its latest legal challenge, it could “destabilize everything” by removing health insurance coverage for many Coloradans.nn“We hope the federal Department of Health and Human Services will quickly approve Colorado’s reinsurance program, which is basically insurance for insurance companies that ultimately helps reduce insurance premiums for consumers,” said Adam Fox, director of strategic engagement, in a statement. “Without reinsurance, consumers will face average increases of 0.5 percent and continue to face very high premiums.”nnOriginal article published on denverpost.com.
