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.

The July release of the Home Health OASIS July 2018 Quarterly Q&As brings promise that CMS is back on track to continue quarterly updates that address agency OASIS questions. Perhaps, one of the most complex responses was the insight provided on “what is” and “what is not” a surgical wound in the context of PleurX catheters.

Check out these tips when coding blindness and low vision. Documentation training and education is crucial to correctly code blindness and low vision conditions. Category-level tabular instruction at H54.- (Blindness and low vision) requires...

Last month, Centers for Medicare and Medicaid Services (CMS) expanded the Targeted Probe and Educate (TPE) to include Hospice.

Centralizing Utilization Review Functions is a cost-saving quality improvement measure, closes gap in coverage due to inter-rater reliability. Many forward-thinking organizations recognize the negative financial impact of inaccurate or non-existent UR. Learn how it's worked for a large, newly formed health system...

With little time until the 2018 Medicare OPPS final rule goes into effect, finance leaders should take action now to address the key issues that may impact their organizations both financially and operationally.

CMS unveiled its new home health prospective payment system (PPS). This brings a major overhaul of how home health care agencies could be paid in 2019...

With CMS is conducting its second round, now is the best time to prepare for Probe and Educate and check up on your compliance plan...

Under the Global Budget Revenue model, hospital revenue must fall within 5% of the cap budget or face a CMS penalty. At a large health system in Maryland, revenue fell 7% under the hospital global cap budget in the fiscal year 2015.