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Health Reform

ObamaCare Signups: More Than Just the Exchange Numbers

April 22, 2014 by David E Williams

Obamacare survives (Fresh Conservative / photopin cc)

President Obama just announced that 8 million people signed up for coverage on federal and state health insurance exchanges during the initial open enrollment period for the Affordable Care Act, aka ObamaCare. But focusing just on the exchanges actually seriously underestimates ObamaCare’s impact.[read more]

Better Medical Marketing with the New (and Free) Medicare Data Set of 880,000 Providers

April 19, 2014 by Chen Sirkis

Medicare data set (photo: longislandwins)

The U.S. medical market has been in turmoil since the U.S. Centers for Medicare and Medicaid Services released a comprehensive data set including all of the $77 billion in Medicare payments paid to over 880,000 physicians in 2012. It identifies by name every physician or provider reimbursed by Medicare.[read more]

ICD-10 Delay: What It Means to You

April 18, 2014 by Andy Salmen

ICD-10 delayed (image: Stuart Miles)

The 10th revision of the International Statistical Classification of Diseases and Related Health Problems introduces a significant change to the coding system. That has some practitioners scrambling to accommodate the over 67,000 coding options in ICD-10.[read more]

HIPAA Privacy and Security Compliance: Should You Care?

April 18, 2014 by David Harlow

security / shutterstock

The HIPAA/HITECH Omnibus Rule became effective just over one year ago. The compliance date was just over six months ago. Within about another six months (plus or minus), Federal regulators – at the Office for Civil Rights at the US Department of Health and Human Services – will begin a new round of HIPAA compliance audits.[read more]

Improving Clinical Outcomes by Addressing Social and Basic Needs

April 17, 2014 by Tim Kilpatrick

address social and basic needs

Our healthcare system is not designed to address social and basic needs. But reducing the cost of healthcare and improving clinical outcomes may be more about addressing the social and basic needs of super-utilizers (50% of all spending) than it is about clinical care.[read more]

Bundled Payments: Rewarding Quality and Value

April 16, 2014 by Linda Ringquist

Transformation to bundled payments

The Medicare reimbursement system is in the process of transforming healthcare as we know it from a traditional fee-for-service model to a system that rewards based on quality, care coordination, accountability, and healthcare cost savings. Here's an outline of benefits and risks.[read more]

Time Thieves

April 15, 2014 by Kathy Nieder

Currency of time

Age forces the recognition that time is the true currency of our lives. When people waste it for you, it is frustrating and angst producing. One of the underlying tragedies of physicians’ daily lives, especially in primary care, is the theft of our time, stolen away by the health care system.[read more]

ICD-10 Delay: Does ICD-10 Lack Clinical Value?

April 13, 2014 by Abby Norman

ICD-10 delay

ICD-10 was delayed once again as part of a bill that was meant to fix the physician reimbursement issues with Medicare. Incidentally, pushing out the date for ICD-10 implementation pleases many physicians. Some have gone so far as to say, on record, that ICD-10 lacks clinical value.[read more]

Should Step Therapy and Prior Authorization Be Outlawed?

April 9, 2014 by David E Williams

photo: torbakhopper / photopin cc

Step therapy and prior authorization are legitimate and even necessary tools. This doesn’t mean that these approaches shouldn’t be scrutinized. Balancing cost, quality, access and convenience in today’s healthcare system is not easy. Making things better requires something more than legislating further restrictions on health insurers.[read more]

Dual-Eligibility: An Overworked and Overlooked Population?

April 9, 2014 by Abby Norman

dual eligibility

9 million Americans are covered by both Medicare and Medicaid and are part of a unique community of healthcare consumers known as the dual eligible. Dual-eligible beneficiaries often have complex health conditions and may be low income, meaning that their access to healthcare would be greatly limited if not for their dual-eligibility for coverage.[read more]

Providers: Shifting Landscape and Mindset

April 8, 2014 by Linda Ringquist

shifting landscape for healthcare providers

As a result of the Affordable Care Act as well as other healthcare legislation, a shift is occurring in healthcare from the provider’s perspective. In order just to survive (not even prosper), physicians are changing the way they conduct business and choosing which patients will be seen.[read more]

Reducing Documentation Costs for Physician Practices

April 7, 2014 by Andy Salmen

reducing documentation costs

Documentation costs for physician services can represent a very significant expense. Upcoming changes to billing and coding, along with the implementation of the Affordable Care Act, will make hospitals and physician practices turn to efficiency improvements as a way to cut costs, without cutting the quality of services.[read more]