Read more from McBee Healthcare Associates about Clinical

Make the Most out of Your Non-Cancer Length of Stay Rates

2020-06-25T16:45:05-05:00Categories: Blog, Hospice|Tags: , , , , , , |

Last October, Palmetto, one of the nation’s largest Medicare Administrative Contractors to the federal government, released their Electronic Comparative Billing Report (eCBR) for 2018 data between April 1 – September 30 that focused on hospice providers’ Non-Cancer Length of Stay (NCLOS) rates.

Critical Steps Every Agency Should Take to Transition LUPAs to PDGM

2021-09-14T11:44:05-05:00Categories: Blog, Home Health|Tags: , , , , |

In the 2020 Patient-Driven Groupings Model (PDGM) environment, LUPAs will become even more complicated with the introduction of the multifaceted structure of visit requirement variables. Like so many other aspects of PDGM, this change in calculation requires your attention.

Patient Driven Groupings Model (PDGM) Readiness Series: Clinical Coding Challenges

2019-12-04T13:12:58-05:00Categories: Blog, Home Health|Tags: , , , , , , |

The Patient-Driven Groupings Model (PDGM) is the most significant change to the home health payment reform in the past two decades.  The impact from PDGM is expected to significantly shift service delivery and will change the structure of home health reimbursements. A key component for calculating payment under PDGM...

Patient Driven Groupings Model (PDGM) Readiness Series: Back Office Preparations

2019-12-02T20:44:04-05:00Categories: Blog, Home Health|Tags: , , , , , |

The Patient-Driven Groupings Model (PDGM), is the most significant change to the home health payment reform in the past 20 years. PDGM completely alters the methodology for calculating payments, and an example of this is the removal of therapy utilization as a component and the payment periods have been reduced from 60 to 30-days...

PDGM: Delivering High-Quality Care in a Resource Efficient Manner

2021-06-08T08:44:05-05:00Categories: Blog, Home Health|Tags: , , , |

More than any of the very complex modifications contained in the Patient-Driven Groupings Model, the most important enhancements emphasize the dire need for all agencies to have a solid and well-functioning episode management program in place before January 1, 2020.

Utilization Review Program Recovers $1.8M in Revenue

2021-05-04T09:29:22-05:00Categories: Blog, Health System, Hospital|Tags: , , |

The Utilization Review (UR) function in the emergency department (ED) serves as a critical component to ensure whether a patient is placed as inpatient or observation. Establishing the UR team to manage patient status at the point of admission is imperative to minimizing denials down the line. Too often, hospitals waste time and money by [...]

Utilization Management Engagement Recovers $1.8M in Additional Revenue in the First 90 Days

2021-07-07T06:59:38-05:00Categories: Case Studies, Health System|Tags: , , |

By implementing improved processes, physician and staff education, tailored operations strategies and increased admission reviews, this engagement slashed observation rates by a third. As a result of working with utilization review staff to achieve correct patient status assignments, the health system experienced a $1.8M revenue improvement in the first three months of the engagement.

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