Report: Florida Has Worst Physician Shortage In Country

According to a new report by the Kaiser Family Foundation, Florida has the worst physician shortage in the country. Areas and population groups with a population-to-provider ratio of 3,500-to-one (or 3,000-to-one in areas of high need) are designed health professional shortage areas (HPSAs), according to experts. The Kaiser Family Foundation report found approximately 6,100 HPSAs nationwide. Florida has more than 252 primary care HPSA designations and meets less than 45 percent of the state’s overall need. Other states with high HPSAs include California, New York, Texas and Illinois. Is it important to note, however, that the report does not account for additional primary care that physician assistants or nurse practitioners could provide-two groups that are often suggested as a way to offset the shortage.

Click here to see the report.

Click here to read more.

Report: States Get More, Spend More On Medicaid Under ACA

According to recent report released by the National Association of State Budget Officers, states are receiving and spending more money on the Medicaid health insurance program. The Affordable Care Act allowed more people to enroll in Medicaid and gave states 90 to 100 percent reimbursements for new enrollees. In fiscal year 2014, the increase in federal funds to states was almost entirely due to additional Medicaid dollars. Although Medicaid spending rose in most states, it was mostly funded by the federal government. Federal funding for Medicaid increased 17.8 percent, but state dollars directed towards it grew only 2.7 percent, according to the report.

Click here to read more.

ICD-10 Implementation Is Less Than A Year Away: What You Need To Do To Be Ready Party III

As we continue our ICD-10 Implementation Is Less Than A Year Away: What You Need To Do To Be Ready series, we’ll take a look at other steps providers can take in the months leading up to implementation.

After you implement changes like educating your staff and assessing the potential reimbursement effect of transition, begin developing strategies to minimize problems and maximize opportunities. In order to do this, assess the impact of decreased coding productivity on your organization’s accounts receivable status. Coding productivity can be affected by a number of factors, including the amount and level of preparation, extent of education, coding experience, extent of ICD-10 training, quality of medical record documentation, and your organization’s size.

Also, assess how long the decline in coding productivity will last and what steps can be taken to reduce the effect of decreased coding productivity. We recommend a few things to assist you in this process. Suggestions include eliminating coding backlogs and prioritizing medical records that need to be coded.

We also recommend monitoring coding accuracy during the initial implementation period and identifying any other problems you may have. Try to implement strategies that reduce any potential negative effect and develop a contingency plan for continuing operations if problems occur when implementation goes live. Additionally, develop a communications plan that outlines steps for how to report an issue when the system goes live, who the points of contacts will be, and how to disseminate information and/or updates to vendors, payers and other business associates.

Stay tuned to our blog for more tips on a smooth ICD-10 transition!

CMS Names First Chief Data Officer

CMS has named Niall Brennan as its first chief data officer to head the new Office of Enterprise Data and Analytics. Brennan is “tasked with overseeing improvements in data collection and dissemination as the agency strives to be more transparent.” Brennan has previously served as the acting director of CMS’ Office of Enterprise Management and has been appointed to the newly created position after leading numerous CMS data programs and initiatives at OEM. CMS is focusing on data transparency by continuing its payment reforms, including changing from volume-based, fee-for-service reimbursements to those focused on outcomes and coordination of care.

Click here to read more.

CMS Clarifies 45-Day Deadline For Documentation Requests

According to a recent Survey & Certification memo, certain auditors that are doing prepayment reviews of Medicare claims must tell providers that they have 45 days to produce any additional documents requested (ADR). This instruction is only for Medicare Administrative Contractors and Zone Program Integrity Contractors who are required to alert providers that failure to respond within 45 calendar days to pre-payment ADR will result in a denial of the claim. The effective date of the instruction from CMS is April 1, 2015.

Click here to access the memo.

Click here to access the related manual update.

Click here to read more.


CMS Hosts Latest Home Health, Hospice and DME Open Door Forum

CMS recently hosted its latest Home Health, Hospice, and DME Open Door Forum. Issues that were discussed include Home Health Conditions of Participation (HHCoPs), the 2015 home health prospective payment system (HHPPS) rate update, Face-to-Face, the Home Health Value-Based Purchasing Model, and the Outcome and Assessment Information Set (OASIS) and Quality Measures. NAHC has a detailed summary of all the home health issues covered. Click here to see it. A summary on the hospice issues that were addressed during the ODF will appear later today in the NAHC Report.

ICD-10 Implementation Is Less Than A Year Away: What You Need To Do To Be Ready Part II

In our last post, we looked at how providers can develop an implementation strategy, including an assessment of the impact of ICD-10 on their organization. This post will explore other key ICD-10 transition steps after your initial assessment.

Start by contacting your business associates periodically to follow up on their readiness status. This includes payers and system vendors. Ask them for updates regarding their ICD-10 transition process and any changes to their readiness timeline. Also, along with your coding staff, continue to increase your familiarity with the ICD-10 code sets and the associated coding guidelines. Inpatient coders should start familiarizing themselves with ICD-10 definitions, such as root operations and approaches.

Next, complete any tasks identified during your impact assessment, including implementing system changes and completing internal testing of system changes. Once vendors, payers and other business associates are ready for testing, begin the testing process and modify or develop policies and procedures from your initial assessment.

Also, start to educate other individuals in your organization (besides coding staff) identified during your assessment. Educate these individuals about differences in the classification of diseases and procedures in ICD-10 and what their role in the ICD-10 transition process will be. Continue to modify the ICD-10 project plan and timelines as needed and assess the quality of medical record documentation. If medical record documentation is lacking, implement documentation improvement strategies and monitor the impact of these strategies. Lastly, this stage should include assessing the potential reimbursement effect of transition; communicate with your payers about these anticipated changes.

Stay tuned to the ICD-10 Implementation Is Less Than A Year Away: What You Need To Do To Be Ready series to learn more tips for a successful transition to ICD-10.