Since the Institute of Medicine’s November 1999 report “To Err is Human,” a new mantra regarding the structure of healthcare delivery and reimbursement emerged. Today, government reimbursement methods increasingly focus on pay-for-performance, pay-for-quality measures, and strict adherence to...Read More »
After a decade of performance-based healthcare payment initiatives, the Department of Health and Human Services decided it was high-time to take a look at the success of those initiatives even as it embarks of additional value-based purchasing (VBP) measures across an array of healthcare...Read More »
Volunteers sought for ICD-10-CM/PCS end-to-end testing set to begin in July. The tests will demonstrate whether CMS systems including Medicare claims, MACs, and the Common Electronic Data Interchange (CEDI) contractors are ready for the ICD-10 implementation.Read More »
Q: I am a relatively new CDI specialist in a relatively new CDI program. We learned that we should be examining the health record with an eye toward “what bought the bed.” When we raise this concept to our coders, however, they disagreed with the premise telling us that such a concept was...Read More »
As hospital and health system finance leaders look for ways to enhance revenue in an era of shrinking margins, many turn their attention to their organization's case mix index (CMI). A higher CMI means more reimbursement dollars for providing care because it indicates that a hospital is treating...Read More »
