Recent Articles
Medicaid beneficiary fluctuations are leading to more costs
Medicaid's "cumbersome" policies often lead to patients not getting or filling their prescriptions, receiving important diagnostic tests, or managing their chronic disease, which will lead to more costs down the road, according to a new report released by the Association for Community Affiliated Plans.
The Medicaid system, which varies by state, requires beneficiaries to show proof more than once a year that they and their children are still eligible for the public program. This leads to many falling off the rolls, which is a cycle that interrupts their continuity of care and jeopardizes their health.
Additionally, with so many people "churning," which means dropping out and back in to the Medicaid rolls every few months, the federal goal of measuring the quality of the patient care has become extremely problematic if not impossible, according to the group, which represents 42 nonprofit safety-net health plans serving six million beneficiaries in 23 states.
Read the full story by HealthLeaders Media's Cheryl Clark.
Hospital’s pre-registration efforts pay off in collections
The last thing you want to learn at your hospital, as a patient sits at your registration desk:
- They can't pay, and no one knew prior to service
- Their insurance changed, and authorization is required
- They recently lost their job and have not paid their COBRA benefits
At this point, you may end up with an unpaid account—and in this economy, that's not good news when hospitals continue to lose reimbursement dollars.
Read the full story by HealthLeaders Media’s Dom Nicastro.
Revenue Cycle Institute posts free ABN Audit Preparation tool
Help ensure your facility properly obtains Advance Beneficiary Notices (ABN) from patients for Medicare noncovered services with an auditing checklist.
Click here to download the sample ABN Audit Preparation tool.
Editor’s note: This sample tool is excerpted from the Medical Necessity Training Toolkit, published by HCPro, Inc.
Care Card technology improves health system’s patient flow and waiting time
At Heritage Valley Health System in Beaver, PA, patient flow was a major concern, as it has been for many facilities nationwide.
The facility was well aware of the long process patients had to go through to be seen by a physician. In 2006, it implemented electronic kiosks along with a Care Card to help the registration process move more efficiently and maintain constant patient flow.
"Modeled in part on successful implementations in both the airline and hospitality industries, the board and senior management of Heritage Valley developed a strategic plan for enabling and promoting greater consumer participation in the healthcare process through various self-service initiatives," says Robert Swaskoski, director of enterprise resource systems at HVHS.
Read the full story by HealthLeaders Media’s Sarah Kearns.
MedicareFind.com launches
HCPro, Inc. is pleased to announce it has launched MedicareFind.com. MedicareFind is a new regulatory database product that allows you to easily find Medicare-related source authorities. You can sort by date and also check just certain years, document types (e.g., transmittals), or sources of information (e.g., OIG, CMS).
Patient access managers may want to check out our “EasyFind” link to ABN-related documents.
You can also read analysis of recent Medicare-related regulations and tips for using the new MedicareFind site on the MedicareMentor Blog -- http://blogs.hcpro.com/medicarefind/
Patient access leaders must remain flexible in difficult economy
Sometimes, your health information managers need to code. And your patient access managers need to register patients.
In these tough economic times, your hospital staff members should be ready for different roles on any given day. No one is immune to change.
At Albany (NY) Medical Center, managers in the patient access department are prepared to handle staff shortages.
During a recent string of illnesses and consecutive days with short staffs, department leaders took off their managers' hats and got on the frontline to register patients.
"The leadership team are working managers, much like any other patient access area," says Cathy Pallozzi, CHAM, patient access director at Albany Medical, noting the staff recently experienced colds and GI, which sprang the managers to action. "So the managers are on the front end, as well as the associate director. If I am needed, I will be on the front end as well."
Read the full story by HealthLeaders Media’s Dom Nicastro.
Get staff members to know HIPAA
The American Recovery and Reinvestment Act includes many changes for HIPAA.
Your patient access staff members should know them.
Here’s a white paper to help them get started:
Have a RAC question? CMS has some answers
Although none of the newest Recovery Audit Contractor FAQs released by CMS—it published 15 in the last two weeks—is particularly surprising, they are perhaps a sign that CMS is continuing to make every effort to share RAC information providers need to know, through as many channels as possible.
It may be sharing the same information during RAC outreach sessions or during Open Door Forum calls, but now the information is also readily available to those who wish to learn about RACs in a Q&A format.
Read the full report by Andrea Kraynak for HealthLeaders Media.
From HFMA: Five ways leaders fail
Editor’s note: The following is a passage on www.healthleadersmedia.com from Philip Betbeze, who attended the Healthcare Financial Management Association’s annual conference last week in Seattle.
Keynote speaker, Patrick Lencioni, kicked off the opening weekday, speaking about Leadership.
Lencioni often works with hospitals to adopt ideas around teamwork. Now, it's more important than ever in these difficult economic times, when everyone is expected to do more with less. He gave us five ways leaders often mess up their teams. Pay attention. I've definitely been on some bad teams and some good ones, and this guy has it right:
1. The absence of trust: Most think about predictive trust, which means we have known each other long enough I can predict your behavior. But that's not what makes a team great. The team we need is based on vulnerability. Vulnerability-based trust happens when human beings on team say things like "I don't know the answer," or, "I think I need help; I think I screwed this up," or even "I'm sorry." When you have that dynamic on team it creates powerful competitive advantage. Vulnerability can never be faked.
2. Fear of conflict: Why don't people like to engage in conflict? They say they don't want to hurt people's feelings. Organizations that think conflict is bad crush people because it ends up as a conflict of people and not issues.
3. Lack of commitment: When we can't get people to debate, people won't commit. If people don't weigh in on a decision they won't buy in on a decision. Truth is if we want to get people to commit we need to make sure we are hearing people and their opinions. My job as leader is to make sure I know what everyone thinks, and if that takes time then so be it and if there is not consensus then it is my job to break the tie. When you can do that, hear everyone, and factor in their input, 99 times out of 100 they will support the decision even if they disagree.
4. Avoidance of accountability: This is the most common and most dangerous of all the dysfunctions. When you walk out of meeting and know that person next to you didn't commit, how much courage will you have to hold them accountable? The thought of letting down a trusted colleague is the biggest motivator. They love their teammates. You find it in firefighters and police. The best teams play for one another.
5. Results: Pay attention to results of team rather than individual needs. You have to make sure you do the best for the hospital, not the department. When there are silos at the top of the organization, they suffer the most. The most important priority is the collective results of the organization.
Read Betbeze’s full report on HealthLeaders Media’s Web site.
Sample survey to patients
I am looking for a sample survey to give to patients. I need feedback to have continuous improvement.
Is anyone willing to share the survey tool they are using?
Carole L. Sraver
Director, Patient Access
Washington Adventist Hospital