Thought Leadership
When it comes to thought leadership and staying informed, we’ve got you covered. See below for recent articles, webinars, and downloadable resources available.
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Blue & Co. has performed many Emergency Department Leveling Reviews for hospitals. The two most utilized leveling criteria are “points-based” or “intervention-based.” In either case, each hospital must determine which facility resources (or attributes) to include within its criteria, and how these resources crosswalk into ED visit levels (99281-99285). This can create significant reimbursement differences […]
In 2019 patient medical debt in the U.S. totaled at least $195 billion, according to an analysis by the Kaiser Family Foundation, a nonprofit organization focusing on national health issues. This is a massive figure and should be looked at as an opportunity for healthcare organizations. A survey conducted by Kaufman Hall in August 2020 […]
In a previous blog post, we talked about how poor insurance verification and authorization processes can cause patients to either not come to therapy or to go to a competitor who can facilitate those processes faster. We know that notwithstanding patient choice, outpatient therapy providers should be able to offer an evaluation appointment within 3 […]
It is that time of year again! The Center for Medicare and Medicaid Services (CMS) has issued the proposed rule that would update Medicare payment policies and rates for the fiscal year (FY) 2023’s Skilled Nursing Facility (SNF) Prospective Payment System (PPS). The Patient Driven Payment Model (PDPM) was implemented on October 1, 2019. This […]
One of the most challenging conversations in any multi-physician practice or specialty-based hospital employed group is about how to create a fair distribution of on-call and/or inpatient hospital service coverage while balancing the duties of an outpatient practice. The COVID-19 pandemic has contributed to clinician burnout, and physicians and Advanced Practice Providers (APPs) place significant […]
“There may be no faster death of a great idea or business than a dysfunctional team”, said Daniel Newman from Principal Analyst of Futurum Research and the CEO of Broadsuite Media Group. Over the last 15 years, hospitals have acquired or employed clinicians and other ambulatory services. Unfortunately, not all employment arrangements are part of […]
Many outpatient therapy departments think of a no-show and cancellation reduction plan as a discharge plan. For example, if a patient does not show up a certain number of times, the organization may have a policy to discharge the patient. There is certainly a place for this for patients who repeatedly no-show and cancel. But […]
Great news for 340B Hospitals affected by COVID-19. On March 15, 2022, President Biden signed into law the $1.5 trillion Consolidated Appropriations Acts, 2022. This bill allows Hospitals that have lost eligibility due to a decrease in their Medicare disproportionate share (DSH) percentage as a result of the COVID-19 public health emergency to regain access […]
The Two Midnight rule, adopted in October 2013 by the Centers for Medicare and Medicaid Services, states that more highly reimbursed inpatient payment is appropriate if care is expected to last at least two midnights; otherwise, observation stays should be used. Original Two Midnight Rule In general, the original Two Midnight rule stated that, Payable […]
Elective surgical practices have suffered significantly since the beginning of the COVID-19 pandemic. Patients seeking elective surgical treatment had their procedures postponed or canceled as hospital systems were striving to preserve bed capacity in anticipation of or in response to a spike in COVID-19 related admissions. Private practices and hospital systems alike lost incredible amounts […]
In 2021, Center for Medicare & Medicaid Services (CMS) issued the No Surprises Act that went into effect on January 1, 2022. This Act provides Federal protections against surprise billing and limits out-of-network cost sharing under many of the circumstances in which surprise bills arise. Prior to this Act, individuals could be “balance billed” for […]
For discharges occurring on and after April 1, 2022, coders will have access to new ICD-10-CM and ICD-10-PCS codes. April 1st will also introduce the new Medicare Code Editor (MCE) edit 20 – Unspecified Code Edit. The 2022 IPPS Final Rule stated there would now be coding updates in both October and April. The goal […]
Healthcare organizations need to pay attention to the amount of time it takes patients to get insurance verification and authorization completed. If the process takes too long, patients will seek treatment at other facilities even if they were referred to your organization. Insurance Verification and Authorization Benchmark Notwithstanding patient choice, outpatient therapy providers should be […]
On January 14, 2022, Centers for Medicare & Medicaid Services updated the Technical Users’ Guide for the Care Compare Nursing Home Five-Star Quality Rating System. While this information will be publicly reported starting in January, it will not be used in the Five-Star Quality Rating System until July 2022. Here is what you need to […]
It’s the second week of January and the Provider Relief Fund reporting portal is open for Period 2 reporting. The portal will remain open until March 31, 2022 and is for reporting on payments received between July 1, 2020 and December 31, 2020. The layout and design of the portal is unchanged from Period 1, […]
Webinars
Rising interest rates and historic inflation are impacting hospital purchasing decisions. Using capital efficiency concepts in making hospital purchasing plans is as important as ever. What is Capital Efficiency? Capital efficiency refers to how effectively a hospital deploys its resources to generate returns. In the context of fixed assets and software purchases, capital efficiency involves […]
Conducting a feasibility study is an essential step in determining the viability of implementing a new healthcare program, service, or project. These studies help healthcare organizations assess the potential risks and benefits of their proposed projects before investing significant time, money, and resources into planning for them. Feasibility Studies 101 Feasibility studies typically involve an […]
If you have attended a continuing education conference in the past year or opened your business’ mail since 2021, you have likely heard that you might be eligible for a tax credit of up to $26,000 per employee! While that might be true, eligibility for the Employee Retention Tax Credit is more nuanced than the advertisements […]
New rules for reporting evaluation and management (E/M) services in most places of service took effect January 1, 2023. The coding and documentation revisions, adopted by the American Medical Association’s CPT Editorial Panel and approved by the Centers for Medicare and Medicaid Services (CMS), substantially simplify code selection and documentation. Effective January 1st, E/M services […]
The Consolidated Appropriations Act of 2023, also known as the “Omnibus” package, was signed into law by President Biden on December 29, 2022. Rural Health Clinics (RHCs) need to be aware of some of the changes that will impact them including new grant opportunities and behavioral health provisions. Opportunities for Rural Health Clinics from the […]
This article has been updated on January 5, 2023. Back in August 2022, CMS was proposing changes to the Medicare Bad Debt listing template that is filed with your organization’s cost report. The new template (Exhibit 2A) has recently been finalized by Medicare and is now required for cost reporting periods beginning on or after […]