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Medicare

CMS will pay $1.9 billion to hospitals in value-based payments for inpatient care

Susan Morse for Healthcare Finance Hospitals will receive $1.9 billion in value-based incentive payments for inpatient care, the Centers for Medicare and Medicaid Services announced yesterday. More hospitals will receive positive payment adjustments in 2020 than negative, CMS said. More than 1,500 hospitals (over 55%) will receive higher Medicare payments under the Hospital Value-Based Purchasing…

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CMS penalizes 2,583 hospitals for high readmissions: 5 things to know

By Ayla Ellison for Becker’s Hospital Review In fiscal year 2020, CMS will penalize 2,583 hospitals for having too many Medicare patients readmitted within 30 days, according to federal data released Sept. 30 cited in a Kaiser Health News report. This is the eighth year of the Hospital Readmissions Reduction Program. To determine penalties for…

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The top financial pressures facing healthcare organizations: 5 leaders discuss

By Kelly Gooch for Becker’s Hospital Review Becker’s Hospital Review asked healthcare leaders to share the factors they believe will pressure hospital finances the most in 2019. Here are their responses, presented alphabetically. Editor’s Note: Responses have been lightly edited for length and clarity. Dawn Bulgarella CFO of the UAB Health System (Birmingham, Ala.) Hospital…

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How to Report Shared/Split Visits

By John Verhovshek, MA, CPC for For the Record  A “shared” or “split” patient visit occurs when both a physician and a qualified nonphysician practitioner (NPP) meet face to face with a Medicare patient on the same date of service. In other words, the work of the physician and the NPP are “combined” into a single…

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DRG Mismatches

By Cheryl Ericson, MS, RN, CCDS, CDIP for For the Record When discrepancies occur, the ensuing reconciliation process serves as a prime opportunity to educate CDI and coding staffs. Reconciliation rates monitor both clinical documentation improvement (CDI) and coding proficiency, a key performance indicator. However, many in leadership positions overlook the importance of trending reconciliation…

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