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Health Plan Data Unlocks Population Health Improvements




Health Leaders Media


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  January 27, 2016 Follow us on FacebookFollow us on TwitterJoin us on LinkedInRSS feed

Health Plan Data Unlocks Population Health Improvements

Rene Letourneau, Senior Editor for HealthLeaders Media

By analyzing claims data, Milwaukee-based Children’s Hospital has measurably increased immunization rates and boosted care delivery and outcomes for some of the city’s most vulnerable citizens. >>>

 

Editor’s Picks

3 Ways Telemedicine is Changing Healthcare

From increasing access to influencing better patient outcomes, health systems are recognizing the benefits of virtual patient visits and remote monitoring—and finding ways to mitigate the costs. >>>

Population Health Really Does Work

At self-insured Houston Methodist, a population health pilot designed for staff members saw 50% of high-risk participants move into the low-risk pool within the first six months. >>>

Workarounds in Hospitals Raise Ethical Questions

A disconnect between how an organization imagines work is happening and what staff feel they must do puts healthcare workers on potentially ethically shaky ground. >>>

Postacute Strategies Vary Widely, Lack Standards

Two studies point to the need for a more thoughtful approach to postacute care strategies because readmission rates are simply not improving for some patients. >>>

How Public / Private Accelerators are Fostering eHealth Innovation

It is no surprise that a growing number of healthcare institutions are seeking partnerships to fund and nourish innovative startups. Massachusetts and New York are at the forefront of fostering such relationships. >>>

Readmission-reducing RED Protocol Adoption Lagging

The creators of the 12-step Re-Engineered Discharge protocol say it saves money, but hasn’t yet been widely or fully adopted. Follow-up studies have shown that problems arise when RED is diluted. >>>

Bringing the Healthcare Quality Message to the Masses

A documentary film honoring the AHRQ and the late John Eisenberg, a health systems research pioneer, also aims to promote health policy and patient safety, says his son, the filmmaker. From MedPage Today. >>>

Intelligence Report

Intelligence Report: The Outpatient Opportunity—Expanding Access, Relationships, and Revenue

In this HealthLeaders Media research report, the reasons behind ambulatory and outpatient care expansion may originate from different strategic points of view, but the tactics and objectives have much in common.
Order Today >>>


News Headlines

Trump calls for Medicare to negotiate drug prices

The Hill, January 27, 2016

Has Obamacare’s Medicaid expansion reached a tipping point?

CNBC, January 27, 2016

Medica, Blue Cross notch big growth in public insurance

Star Tribune, January 27, 2016

Health insurer Centene missing data drives with client information

Reuters, January 26, 2016

CBO lowers estimated Obamacare sign-ups by 40%

The Hill, January 26, 2016

Fidelity moves deeper into healthcare space with new exchange

Boston Business Journal, January 26, 2016

Deficiencies found at Theranos lab

The Wall Street Journal, January 25, 2016

Drug shortages in American ERs have increased more than 400%

Chicago Tribune, January 25, 2016

Law keeps ID health insurance CEO’s salaries secret

SFGate.com / Associated Press, January 25, 2016

Broward Health CEO kills himself, sheriff’s office says

Sun Sentinel, January 25, 2016

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Our award-winning Daily News & Analysis e-newsletter can keep your leadership team abreast of relevant breaking news, and with in-depth industry coverage through 10 weekly e-newsletters that hit every pillar of healthcare, we’ve got your whole leadership team covered. Subscribe to any — or all — of our e-newsletters.

Multimedia/Events

Webcast: Building Reputation, Managing Risk—ProMedica’s Model

Date: February 9, 2016, 1:00–2:00 p.m. ET
In this expert webcast, learn how establishing a proactive program to build reputation capital, manage reputational risk, and create a collaborative connection will better prepare providers for dealing with crises in the future.
Register Today >>>

From HealthLeaders Magazine

Big Ideas

What big ideas have you enacted? What big opportunities await your organization? >>>

 

Ups and Downs of High Volume

 

Remaking the Board

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HCPro.com – Health Plan Insider

MDM Data points

Need help to clarify with our providers.
If a test is done in the office & the physician does the visualization & interpretation of the result can you give them 2 data points under MDM? Tests are being billed. Noridian is our MAC but I can’t find anything regarding this when the tests are done in house.
Example:
Patient has PFT’s done in house by technician, the physician reads the tracing & interprets it & discusses the results with the patient & uses this information in their decision about treatment.

Any help is greatly appreciated!

Medical Billing and Coding Forum

Preliminary MIPS Performance Data Available

Clinicians who participated in the Merit-based Incentive Payment System (MIPS) last year can now access preliminary performance feedback data. The final MIPS scores and feedback data for 2017 will be available in July. Clinicians can access their performance feedback and scores with their Enterprise Identity Data Management (EIDM) credentials on the Quality Payment Program website. Between […]
AAPC Knowledge Center

Data breach may have affected over 500,000 patients

LifeBridge Health in Baltimore notified more than 500K patients last week. They were informed that their personal information may have been compromised during a security breach in 2016 (around September). Becker’s Hospital Review was told on May 23rd that on March 18th, malware was discovered on the server that hosts ePHI data for the affiliated physician’s group and the registration and billing systems.

Click here for full story!

The post Data breach may have affected over 500,000 patients appeared first on The Coding Network.

The Coding Network

MDM- “Amount and/or Complexity of Data Reviewed”

I am in need of some advice on some records I’m reviewing. This is directly related to the "Amount and/or Complexity of Data Reviewed" of the MDM component.

If the Physician notes she performs a "Urine Toxicology Screening", checking for RX compliance, and mentions she personally "reviewed the dipstick herself which provides a preliminary result for the potential of more or more drugs", how many points does this qualify for?

One total, for the review and/or order of clinical labs?
Two total, for the independent visualization of a specimen?
Three total, for ordering/reviewing and also independent visualization?

I’ve seen many conversations about this, but no hard documentation that says truly which one. I’ve researched in Optum’s Evaluation and Management Coding Advisor and it isn’t answered for my scenario. I’ve Googled and can only find opinions, but nothing from bigger reputable sources. If anyone has something in writing I would greatly appreciate it!

Thanks so much!

Medical Billing and Coding Forum

Hackers Using Imagers to Access Your Data

Your imaging machine may be looking through more than your patients. The data company Symantec warns providers and facilities that a hacker group named Orangeworm is using software used to control X-ray and magnetic resonance imaging (MRI) machines to access personal health information (PHI) and other data. Symantec admits the exact motives of the group […]
AAPC Knowledge Center