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Tag Archives: Plan

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.
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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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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.
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From HealthLeaders Magazine

Big Ideas

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

 

Ups and Downs of High Volume

 

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HCPro.com – Health Plan Insider

Care Plan and E/M

I code for some Chiropractors that do not adjust until the patient’s second visit. At the second visit, the Dr. will discuss their findings from the XRay, and create a Care Plan- Educating the patient on how often they need to be seen and what exercises they can do to speed up the process. They also spend a fair amount of time discussing the billing aspect- How much they predict insurance will pay, and what will be out of pocket.
They then perform the first adjustment. The appointment typically lasts 30-45 min- only about 10 of which are spent as the adjustment.

I told the Chiropractors that I believe that they can bill a low level E/M with -25 modifier in addition to the adj. code. They would like additional documentation backing this up.

Does anyone have any opinions or information that I could present to the doctors?

Thanks!

Medical Billing and Coding Forum – Chiropractic