Long Term Care Costs Continue To Rise

According to a recent report by Genworth Financial, the cost of long-term care is rising. The findings show the daily cost of a private room in a nursing home at $230 a day compared to $115 a day at an assisted-living facility. Those able to receive home care homes will pay an average of $19 an hour for a licensed home health aide.

Click here to read more. Click here to see how Connecticut compares to national averages.

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Preparing For ICD-10: Everything Will Change

ICD-10 implementation will alter the way coding is currently done and will require a significant effort to execute.  Below is an overview of the people that will be impacted by ICD-10 implementation and the potential effect it will have on your practice.

  • Physicians:  Physicians will have to familiarize themselves with thousands of new codes as code sets will increase fivefold.  Physicians will also be required to provide more specific documentation to patient records.
  • Nurses: Nurses will need to revise order forms to comply with ICD-10 coding, as well as modify prior authorization documents.  Like physicians, nurses will need to provide more specific documentation to patient records.
  • Clinical Staff: Clinical staff will need to develop new policies and forms, rework superbills and reformat Advanced Beneficiary Notices (ABNs).  Create several superbills for different types of visits depending on the volume of codes ICD-10 will introduce to the practice.
  • Practice Managers: Practice managers will need to establish new policies and procedures in conjunction with ICD-10.  In addition, software upgrades should be performed and vendor contracts amended.
  • Coding Specialists: Coders will need to become familiar with revised codebooks and thousands of new codes. Coders should also be prepared to increase their clinical knowledge and be prepared for simultaneous billing of ICD-9 and ICD-10 code sets.
  • Billing: Billing staff should learn new code set and software modifiers and revised payer policies.
  • Lab: Labs will need to understand more specific documentation requirements as well as reporting provisions.

Study: Medicare Cost Variations Result Of Health Differences

A study published earlier this week concludes health differences around the country explain between 75% and 85% of the cost variations, defeating the idea that uneven Medicare spending around the country is due to wasteful practices and over treatment.

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Physicians, Nurses & Allied Health Professionals Open Door Forum

The Centers for Medicare & Medicaid Services (CMS) Physicians, Nurses & Allied Health Professionals Open Door Forum is scheduled for Tuesday, June 4 at 2:00 p.m.(ET). Agenda items include:

  • Place of Service FAQs
  • Health Insurance Marketplace
  • Billing of Intensive Behavioral Therapy for Obesity in Group Settings
  • Revalidation
  • PECOS Release
  • Ordering & Referring
  •  ICD-10

Please dial (800) 837-1935 and reference conference ID# 78869207 at least 15 minutes before the start time.

Click here for more information.

CMS Revises Discharge Planning Guidelines

The Centers for Medicare & Medicaid Services (CMS) has revised the State Operations Manual’s Hospital Appendix A, Interpretive Guidelines for Hospitals, Condition of Participation to clarify the discharge planning requirements for hospitals.

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Lack Of Hospital Hand Washing Costs $30B Annually

HMS Healthcare Management SolutionsStudies show without encouragement, hospital workers wash their hands as little as 30% of the time that they interact with patients. And with hospital-acquired infections costing $30 billion and leading to nearly 100,000 patient deaths a year, hospitals are willing to try almost anything, including video monitoring, to reduce the risk of transmission.

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Scaling Back To Avoid Cadillac Tax

While the Patient Protection & Affordable Care Act (PPACA) has garnered attention for providing coverage to tens of millions of uninsured Americans, workers with employer-paid health insurance are being impacted. Companies hoping to avoid the Cadillac Tax, which penalizes companies that offer high-end health care plans to their employees, are beginning to scale back traditionally offered health benefits in an effort to bring down the overall cost of care.

Click here to read more.