Performance Dashboard for Congested Heart Failure
Performance measurements and the establishment of quality performance targets is important in carrying out any change in practice and make improvements when necessary.
• 100 percent of covered hospital charges for 365 additional days after all Medicare hospital…
1. List at least two major reasons that Medicare administrators turned to the prospective payment concept for Medicare beneficiaries.…
The Emergency Medical Treatment and Labor Act was passed as a feature of the Consolidated Omnibus Budget Reconciliation Act of 1986. This federal law requires the stabilization and treatment of the patient who arrives at the emergency department, regardless of the individual’s insurance status or ability to pay for services. By law, public and private hospitals are forbidden to repudiate treatment of the patient in an emergency, transfer the patient to another hospital before he is stabilized, or stop treatment altogether because the patient cannot afford the cost of care (EMTALA). Transfers actually served as essential motivation for EMTALA. Studies conducted in the early 1980s revealed 250,000 transfers a year from private to public or Veteran Health Administration hospitals, and almost 90%…
briefing, "How is it possible that we spend more money on healthcare than any other…
High 30-day readmission rates have become problematic for many facilities. The Centers for Medicare & Medicaid Services (CMS) have put emphasis on readmission rate reductions for hospitals (“Readmissions Reduction Program”, n.d.). The stress of high readmission rates weighs heavy on facilities as a result of the Affordable Care Act (ACA) which requires CMS to reduce payments to hospitals with excess admissions (“Readmissions Reduction Program”, n.d.). Incorporating Project Re-Engineered Discharge (RED) as part of the discharge process at a small hospital will impact the facility’s readmission rates. Utilizing an evidence based practice (EBP) model can assist advance practice nurses (APN) in creating a system change. A synthesis of evidence…
The CMC must maintain its excellent reputation in servicing the communities of Medicare and Medicaid, and people with less cost insurance. In contrast, CMC must apply operational strategy to reduce identified significant weakness in the area of readmission of heart failure and pneumonia. Its strategic management is relevant to better unlock the advantages in the contrasting competitive advantage.…
5) Centers for Medicare & Medicaid Services (CMS). (2012). Medicare and Medicaid programs; reform of hospital and critial access hospital conditions of participation. Final rule. Federal Register, 77(95), 29034-76.…
M.G., a “frequent fl ier,” is admitted to the emergency department (ED) with a diagnosis of heart failure…
Memorial Hermann does not have the right number of physicians, beds, operating rooms, MRIs and other facilities for a new type of payment environment where the financial incentives will change. The distribution of facilities, which works well in the current fee-for-service environment, is too expensive for the anticipated…
As servants of the people of North Carolina, government has the responsibility to work in the best interests of the its residents. After careful research and consideration, the conclusion has been drawn the expanding Medicare eligibility, under the guidelines associated with the 2010 Affordable Care Act (ACA), would best meet that interest. This conclusion was based on four factors and determinations listed below:…
For some of the most common conditions treated in hospitals, as many as one in five patients is readmitted within 30 days of his/her discharge, reports the Federal Agency for Healthcare Research and Quality. Being readmitted has consequences. For one, readmissions cost Medicare an estimated 17.5 billion a year, as hospitals bill the government for the care. But the toll readmission takes on patients and their families is incalculable. “The most important problem of readmission is not the cost, but the fact that patients are ending up back in the hospital,” David C. Goodman, M.D. co-principal investigator of the Dartmouth Atlas of the Healthcare, said. “That means they have gotten sicker, or that there is a failure to care for them in the community.”…
Voelker, Rebecca. (2014). Community Health centers and their patients take a big hit in Medicaid opt-…
While new patient models take effect, declining reimbursements and increasing compliance risk are adding pressure to the profitability of medical groups. As a gap grows in between payment updates and practice costs, there is a critical need for an optimized revenue cycle that allows for faster payments without further burden on staff.…
would be the health care spent to keep many of the people who live on machines…
5.2 million families more in PhilHealth, construct/repair regional and provincial hospitals and fund immunization programs.…