CMS is requesting providers to submit information regarding their concerns, suggestions, and comments on the proposed changes to help patients. The deadline for providers to take part in this request is August 12th. For more information, read the information below. nnnThere is so much talk in the medical community about the proposed “Patients over Paperwork” initiative that many providers have found themselves at a loss for what will happen next. Common questions surrounding this important topic include: What type of documentation changes will help reduce the amount of administrative burden our clinicians currently face? How will documentation changes affect their practice? How will this impact reimbursement? What does this mean for their patient interaction and day-to-day routine? Is there anyone I can talk to so that my concerns are heard?nnIn June of this year, CMS put out another request for information from providers to voice their concerns, suggestions, and comment on proposed changes. Do not delay however because the deadline for this round of comments closes on August 12th. Specific feedback that CMS is looking for can be found by visiting federalregister.gov, where you can also submit your comments. Your participation in this initiative does not have to stop with this RFI. CMS frequently releases opportunities for public comment to address specific areas of concerns and providers should prioritize to take advantage of these opportunities.
Wednesday nights democratic primary debate was dominated by talks of healthcare by the candidates. The discussions ranged from health policies to the skyrocketing drug prices which are among the key issues of the candidates. Each had different views on the topic of healthcare. Read the article below to find out what some of their ideas are and what they think they could do to better the healthcare system.nnDuring Wednesday night’s Democratic presidential primary debate — the first in a two-night event viewed as the de facto launch of the primary season — health policies, ranging from “Medicare for All” to efforts to curb skyrocketing drug prices, were among the key issues the 10 hopeful candidates onstage used to help differentiate themselves from the pack.nnHealth care dominated early, with Sens. Elizabeth Warren (Mass.) and Cory Booker (N.J.) using questions about the economy to take aim at pharmaceutical and insurance companies. Sen. Amy Klobuchar (Minn.) emphasized the difficulties many Americans face in paying premiums.nnBut the candidates broke ranks on the details and not all of their claims stayed strictly within the lines.nnOnly two candidates — New York City Mayor Bill de Blasio and Warren — raised their hands in favor of banishing private insurance to install a government-sponsored Medicare for All approach.nnKlobuchar, a single-payer skeptic, expressed concern about “kicking off half of America off their health insurance in four years.” (That’s correct: In 2017, a majority of Americans had private coverage, with 49% getting that insurance through work, according to the Kaiser Family Foundation.)nnFormer Texas Rep. Beto O’Rourke, who also supports maintaining a private insurance system, outlined his own universal health care plan, based on a “Medicare for America” bill in Congress.nnThe single-payer talk set off other discussions about the role of health insurance and the cost of care. We fact-checked some of the biggest claims.nnWarren: “The insurance companies last year alone sucked $23 billion in profits out of the health care system. $23 billion. And that doesn’t count the money that was paid to executives, the money that was spent lobbying Washington.”nnWe contacted Warren’s campaign, who directed us to a report from the National Association of Insurance Commissioners, a nonpartisan group of industry regulators. It supports her assessment.nnThe report says that in 2018, health insurers posted $23.4 billion in net earnings, or profits, compared with $16.1 billion a year prior.nnThis came up in the context of Warren’s support for eliminating private insurance under a Medicare for All system. However, the financing and price tag of such a system is unclear.nnBooker: “The overhead for insurers that they charge is 15%, while Medicare’s overhead is only at 2%.”nnThis is a flawed comparison. Booker said administrative overhead eats up much more for private carriers than it does for Medicare, the government insurance program for seniors and the disabled. But Medicare piggybacks off the Social Security Administration, which covers costs of enrollment, payments and keeping track of patients.nnAlso, Medicare relies on private providers for some of its programs, and overhead charges there are higher. Medicare’s overhead is less than that of private carriers, but exact figures are elusive.nnThe insurance companies’ trade group, America’s Health Insurance Plans (AHIP), reported in 2018 that 18.1% of private health care premiums went to non-health care services. That includes taxes of 4.7% and profits of 2.3%. The Medicare trustees reported that in 2018, total expenses were $740.6 billion, with administrative expenses of $9.9 billion. That comes to 1.3%, less than Booker said.nnWarren: “I spent a big chunk of my life studying why families go broke, and one of the No. 1 reasons is the cost of health care, medical bills. And that’s not just for people who don’t have insurance. It’s for people who have insurance.”nnIs the No. 1 reason people go broke the cost of health care? We’ve rated similar statements Half True — partially accurate but lacking important context.nnOriginal article from khn.org
In this video, we found there are 5 habits of exceptionally charismatic people! We all know people who exude charisma and always leave the best impression and charm to everyone in the room, and it has been found that charisma can be learned. From her book, Vanessa Van Edwards identifies 5 habits that exceptionally charismatic people follow. Learn why charisma matters and how you can use people skills and body language to adjust your presence and more positively influence everyone around you!nn
UnitedHealth Group has purchased DaVita Medical Group after they reached a settlement with the Federal Trade Commission saying this deal was a long time coming. This was due to the concern about harm to medical competition in Nevada. The original deal in place would have resulted in a monopoly controlling more than 80% of the medical market.nnUnitedHealth Group announced Wednesday it has closed on its $4.3 billion purchase of DaVita Medical Group after the parties reached a settlement with the Federal Trade Commission that resolves the federal government’s concerns about harm to competition in Nevada.nnUnder the FTC settlement, UnitedHealth Group has agreed to sell DaVita Medical Group’s Las Vegas operations, known as HealthCare Partners of Nevada, to Salt Lake City, Utah-based Intermountain Healthcare within 40 days of the deal’s closing. Without that tweak, the FTC said the deal would reduce competition in the Las Vegas area for managed care provider organization (MCPO) services sold to Medicare Advantage insurers and Medicare Advantage plans sold to individual Medicare Advantage members.nnThe original FTC complaint against the proposed deal said it would result in a near monopoly controlling more than 80% of the market for services delivered by MCPOs to Medicare Advantage insurers.”The complaint alleges that elimination of this competition would increase healthcare costs and decrease competition on quality, services and other amenities in the affected area,” the FTC wrote.nnColorado Attorney General Phil Weiser separately announced his office had reached an agreement with UnitedHealth Group and DaVita that resolves its concerns about anticompetitive effects in the Colorado Springs area for people covered under Medicare Advantage plans.nnDaVita Medical Group owns two physician groups in Colorado Springs, and UnitedHealthcare, a sister company to Optum, is the largest Medicare Advantage operator in the region. Weiser filed a complaint independent of the FTC to challenge the Optum-DaVita deal.nnUnder that deal, UnitedHealthcare will lift its exclusive contract with Centura Health for at least 3.5 years, which will expand the network of providers available to seniors covered under Medicare Advantage, Weiser’s office said in a news release. Additionally, DaVita Medical Group’s agreement with Humana, UnitedHealth Group’s competitor in Colorado Springs, will be extended without change at least through the end of 2020.nn”As the people’s lawyer, I am committed to protecting all Coloradans from anticompetitive consolidation and practices, and will do so whether or not the federal government acts to protect Coloradans,” Weiser said in a statement.nnUnitedHealth Group will combine DaVita Medical Group with its Optum subsidiary, which provides primary and secondary care, consulting and data analytics. Optum spokeswoman Lauren Mijajlov wrote in an email that the company is pleased to have reached an agreement with Weiser’s office, and to have closed the deal. DaVita spokeswoman Courtney Culpepper said the same in an email.nnComplete and original article posted on modernhealthcare.com
CMS is requesting feedback on ways to reduce the administrative and regulatory burden with aligning and simplifying coding and documentation requirements. The comment period will close on August 12, 2019, at 5:00 p.m. EDT.nnOn June 11, CMS published a Request for Information (RFI) as part of its Patients Over Paperwork initiative to collect public input on ways to reduce unnecessary administrative and regulatory burden.nnThis is not the first time CMS has sought feedback on methods to reduce administrative burden. Through previous listening sessions and RFIs, CMS collected thousands of comments and is actively working on addressing those comments deemed actionable. The current RFI aims to collect feedback on several specific topics that have not yet been addressed. These include:n
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Aligning Medicare, Medicaid, and other payer coding, payment, and documentation requirements
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Enabling feedback and data sharing to support patient care and the clinician-patient relationship
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Recommendations for when and how CMS issues regulations and how CMS can simplify rules and policies for beneficiaries, clinicians, and providers
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Streamlining reporting and documentation requirements or processes to monitor compliance
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nRespondents should provide clear, complete comments and should include, when possible, data and specific examples. The comment period closes on August 12, 2019, at 5:00 p.m. EDT.nnOriginal article posted on revenuecycleadvisor.com
Do you have a complicated surgery case that needs help with coding? Welter Healthcare Partners would love to help! Please upload the operative note by clicking on the link below. Remember to remove ALL patient protected health information and organization identifiers. Welter Healthcare Partners will not use any medical records submitted in which PHI is not removed and protected.nnnn– Click Here to Submit Redacted Surgery Case Study –nn nnADMISSION DATE: 11/28/2017nnnSURGERY DATE: 11/28/2017nnSURGEON: Dr. G, MD PREOPERATIVE DIAGNOSES:n
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Degenerative lumbar spine (L4-L5).
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Obesity (BMI 32).
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History of multiple surgeries including umbilical hernia repair with mesh.
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nPOSTOPERATIVE DIAGNOSES:n
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Degenerative lumbar spine (L4-L5).
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Obesity (BMI 32).
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History of multiple surgeries including umbilical hernia repair with mesh.
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nOPERATION:n
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Unusually difficult anterior exposure for lumbar spine arthroplasty (L4- L5).
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lntraoperative fluoroscopy.
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Vessel Guard patch.
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Abdominal x-ray reading.
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nSPINE SURGEON: M E J. DOnnASSISTANT: M M, SAnnANESTHESIA: General endotracheal.nnESTIMATED BLOOD LOSS: Minimal during my part of the surgery.nnCOMPLICATIONS: None.nnFINDINGS: Very large osteophytes making the vascular dissection extremely difficult in addition to the obesity and scar tissue from the umbilical hernia repair with mesh.nnSPECIMENS REMOVED: None during my part of the surgery.nnINDICATION FOR SURGERY: This is a 56-year-old male with an early stage of obesity, who has a degenerative lumbar spine and needs anterior exposure for lumbar spine arthroplasty at the level of the disk L4-L5. The patient had multiple prior abdominal surgeries including right adrenalectomy and umbilical hernia repair with mesh.nnPROCEDURE IN DETAIL:nnThe patient was brought into the operating room and placed on the table in the supine position. After the general anesthesia was administered, the intraoperative fluoroscopy was used to identify the level of the disk L4-L5 and the projection of the disk at the level of the anterior abdominal wall was marked with a transversal line in the abdomen, which was immediately below the umbilical scar. At this point, the abdomen was prepped and draped in the usual sterile fashion. Due to the obesity of the patient and expected scar from the umbilical hernia repair, it was decided to proceed with longitudinal incision, which was placed at the level of the midline, a little bit to the left of the midline below and above the previously placed line with incision extended from the infraumbilical area towards the left side of the umbilical area. The incision was deepened through the subcutaneous tissue and through the fascia. The fascia! flaps were elevated and the left rectus muscle was retracted as lateral as possible. In the upper part of the incision, this dissection was more difficult due to the scar tissue from the previously placed mesh, and the mesh was encountered at this level and needed to be divided a little bit to complete mobilization of the rectus abdominis muscle. In the lower part of the incision below the arcuate line, the retroperitoneal space was entered. A little bit more difficult dissection of the retroperitoneal space was encountered, particularly in the upper part of the abdomen due to the obesity of the patient and probably stiffness of the tissue from the prior surgery. The retroperitoneal space was entered and at this point, the heavy peritoneal sac was carefully dissected and mobilized together with the ureter and pushed to the right side. The ureter was carefully protected. The vascular dissection was started above the left iliac vessel.nnKeeping the dissection close to the lateral wall of the left iliac artery, this artery was mobilized as distal as possible close to the groin. The patient had a rather large amount of fat and also stiff inflamed lymph nodes covering the iliac vessels making the vascular dissection quite very difficult. Using gentle blunt dissection, the iliac vessels were progressively.started to be dissected and pushed to the right side. On the left side of the disk space L4-L5, quite very large osteophytes were encountered. After this initial step of vascular dissection although very difficult, was completed with no incidents. The dissection was further continued using gentle blunt dissection. Below the disk space L4-L5, tedious dissection was done through the inflamed fat and lymphatic tissue to look for the iliolumbar vein and in the vicinity of the disk space, no iliolumbar vein was identified. This dissection allowed further mobilization of the lower part of the iliac vein, which was possible to be pushed further to the right side. Although the dissection of the iliac vessel was rather more extended than normal, it was still extremely difficult to push the vessels all the way to the right side of the spine encountering the right side of the spine also very large osteophyte. At this point, the needle was inserted in the disk exposed and using intraoperative fluoroscopy, the level of the spine exposure was demonstrated. The SynFrame was placed maintaining the exposure al the level of the disk L4–L5 with the impression that the vessels were mobilized all the way to the right side above and to the right of the larger osteophyte in the right side of the spine. It was rather unusually difficult dissection, which was completed at this point with no incidents. At this point, Dr. J came into the operating room and the case was turned to Dr. J for the orthopedic part of the spinal procedure. During the surgery performed by Dr. J, he noticed that it is impossible to obtain dissection on the right side of the spine and asked me to come back to the operating room and to proceed further mobilization of the iliac vessels. I came back to the operating room and I have noticed that now with additional release and destruction of the disk space L4-L5, it was possible with additional blunt dissection to push the left iliac vessel completely further to the right side and it was possible to keep in place these vessels all the way to the right side of the spine with reverse lip retractor. After this was completed with no incidents, I discussed with Dr. J the anatomical landmarks and he felt that now he would be able to complete the procedure with complete diskectomy all the way to the right side of the disk space. I turned the case back to Dr. J for his completion of surgery and after his part of the surgery was completed, I came back to the operating room and I took over the case again. Very good hemostasis was noted. No injury was seen. At this point, a 5 x 7.5 Vessel Guard patch was chosen and was sutured in place with 2 stitches with 4-0 PDS suturing the right side of the patch to the right side of the spine. The patch was able to cover completely the artificial disk implanted and the entire anterior aspect of the spine exposed. At this point, very carefully and gently the retractor blades were removed allowing the great vessels, the left iliac vessels, and the peritoneal sac to come back in a normal anatomical position on top of the patch. At the end of the procedure, very good hemostasis was noticed. Very good flow through the left iliac vessels. No ureteral injuries and no lymphatic leak. At this point, the abdomen was closed in a standard fashion using continuous running #1 looped PDS for the fascial layer. The subcutaneous tissue was irrigated. Local anesthesia was injected. At this point, the intraoperative fluoroscopy was used to x-ray the abdomen for the instrument count and no instruments were found in the surgical field. The subcutaneous tissue was closed with continuous running 2-0 Vicryl and the skin was closed with continuous running 4-0 Monocryl subcuticular closure. Steri-Strips and sterile dressing were applied. The patient tolerated the procedure well and left the operating room in stable condition.
nnThere is so much talk in the medical community about the proposed “Patients over Paperwork” initiative that many providers have found themselves at a loss for what will happen next. Common questions surrounding this important topic include: What type of documentation changes will help reduce the amount of administrative burden our clinicians currently face? How will documentation changes affect their practice? How will this impact reimbursement? What does this mean for their patient interaction and day-to-day routine? Is there anyone I can talk to so that my concerns are heard?nnIn June of this year, CMS put out another request for information from providers to voice their concerns, suggestions, and comment on proposed changes. Do not delay however because the deadline for this round of comments closes on August 12th. Specific feedback that CMS is looking for can be found by visiting federalregister.gov, where you can also submit your comments. Your participation in this initiative does not have to stop with this RFI. CMS frequently releases opportunities for public comment to address specific areas of concerns and providers should prioritize to take advantage of these opportunities.
Health care dominated early, with Sens. Elizabeth Warren (Mass.) and Cory Booker (N.J.) using questions about the economy to take aim at pharmaceutical and insurance companies. Sen. Amy Klobuchar (Minn.) emphasized the difficulties many Americans face in paying premiums.nnBut the candidates broke ranks on the details and not all of their claims stayed strictly within the lines.nnOnly two candidates — New York City Mayor Bill de Blasio and Warren — raised their hands in favor of banishing private insurance to install a government-sponsored Medicare for All approach.nnKlobuchar, a single-payer skeptic, expressed concern about “kicking off half of America off their health insurance in four years.” (That’s correct: In 2017, a majority of Americans had private coverage, with 49% getting that insurance through work, according to the Kaiser Family Foundation.)nnFormer Texas Rep. Beto O’Rourke, who also supports maintaining a private insurance system, outlined his own universal health care plan, based on a “Medicare for America” bill in Congress.nnThe single-payer talk set off other discussions about the role of health insurance and the cost of care. We fact-checked some of the biggest claims.nnWarren: “The insurance companies last year alone sucked $23 billion in profits out of the health care system. $23 billion. And that doesn’t count the money that was paid to executives, the money that was spent lobbying Washington.”nnWe contacted Warren’s campaign, who directed us to a report from the National Association of Insurance Commissioners, a nonpartisan group of industry regulators. It supports her assessment.nnThe report says that in 2018, health insurers posted $23.4 billion in net earnings, or profits, compared with $16.1 billion a year prior.nnThis came up in the context of Warren’s support for eliminating private insurance under a Medicare for All system. However, the financing and price tag of such a system is unclear.nnBooker: “The overhead for insurers that they charge is 15%, while Medicare’s overhead is only at 2%.”nnThis is a flawed comparison. Booker said administrative overhead eats up much more for private carriers than it does for Medicare, the government insurance program for seniors and the disabled. But Medicare piggybacks off the Social Security Administration, which covers costs of enrollment, payments and keeping track of patients.nnAlso, Medicare relies on private providers for some of its programs, and overhead charges there are higher. Medicare’s overhead is less than that of private carriers, but exact figures are elusive.nnThe insurance companies’ trade group, America’s Health Insurance Plans (AHIP), reported in 2018 that 18.1% of private health care premiums went to non-health care services. That includes taxes of 4.7% and profits of 2.3%. The Medicare trustees reported that in 2018, total expenses were $740.6 billion, with administrative expenses of $9.9 billion. That comes to 1.3%, less than Booker said.nnWarren: “I spent a big chunk of my life studying why families go broke, and one of the No. 1 reasons is the cost of health care, medical bills. And that’s not just for people who don’t have insurance. It’s for people who have insurance.”nnIs the No. 1 reason people go broke the cost of health care? We’ve rated similar statements Half True — partially accurate but lacking important context.nnOriginal 
UnitedHealth Group has purchased DaVita Medical Group after they reached a settlement with the Federal Trade Commission saying this deal was a long time coming. This was due to the concern about harm to medical competition in Nevada. The original deal in place would have resulted in a monopoly controlling more than 80% of the medical market.nnUnitedHealth Group announced Wednesday it has closed on its $4.3 billion purchase of DaVita Medical Group after the parties reached a settlement with the Federal Trade Commission that resolves the federal government’s concerns about harm to competition in Nevada.nnUnder the FTC settlement, UnitedHealth Group has agreed to sell DaVita Medical Group’s Las Vegas operations, known as HealthCare Partners of Nevada, to Salt Lake City, Utah-based Intermountain Healthcare within 40 days of the deal’s closing. Without that tweak, the FTC said the deal would reduce competition in the Las Vegas area for managed care provider organization (MCPO) services sold to Medicare Advantage insurers and Medicare Advantage plans sold to individual Medicare Advantage members.nnThe original FTC complaint against the proposed deal said it would result in a near monopoly controlling more than 80% of the market for services delivered by MCPOs to Medicare Advantage insurers.”The complaint alleges that elimination of this competition would increase healthcare costs and decrease competition on quality, services and other amenities in the affected area,” the FTC wrote.nnColorado Attorney General Phil Weiser separately announced his office had reached an agreement with UnitedHealth Group and DaVita that resolves its concerns about anticompetitive effects in the Colorado Springs area for people covered under Medicare Advantage plans.nnDaVita Medical Group owns two physician groups in Colorado Springs, and UnitedHealthcare, a sister company to Optum, is the largest Medicare Advantage operator in the region. Weiser filed a complaint independent of the FTC to challenge the Optum-DaVita deal.nnUnder that deal, UnitedHealthcare will lift its exclusive contract with Centura Health for at least 3.5 years, which will expand the network of providers available to seniors covered under Medicare Advantage, Weiser’s office said in a news release. Additionally, DaVita Medical Group’s agreement with Humana, UnitedHealth Group’s competitor in Colorado Springs, will be extended without change at least through the end of 2020.nn”As the people’s lawyer, I am committed to protecting all Coloradans from anticompetitive consolidation and practices, and will do so whether or not the federal government acts to protect Coloradans,” Weiser said in a statement.nnUnitedHealth Group will combine DaVita Medical Group with its Optum subsidiary, which provides primary and secondary care, consulting and data analytics. Optum spokeswoman Lauren Mijajlov wrote in an email that the company is pleased to have reached an agreement with Weiser’s office, and to have closed the deal. DaVita spokeswoman Courtney Culpepper said the same in an email.nnComplete and original 
nnThis is not the first time CMS has sought feedback on methods to reduce administrative burden. Through previous listening sessions and RFIs, CMS collected thousands of comments and is actively working on addressing those comments deemed actionable. The current RFI aims to collect feedback on several specific topics that have not yet been addressed. These include:n
nn