News
Healthgrades Rankings are out; How Much do they Matter to your Hospital?
By Brian Murphy Healthgrades has released its annual awards, including America’s Best 50, 100, and 250 Hospitals. You can view complete details in the link below. But how much do they really matter? These are broken out by state; in my home state of Massachusetts Lahey Hospital and Medical Center has now earned a third…
Read MoreCommon CC/MCC diagnoses of focus
What complication/comorbidities (CC) and major CCs (MCCs) are common sources of clarification in your healthcare organization or hospital? I have a good idea of what they probably are but am genuinely curious about yours; leave a comment below. We’ve got long lists in places such as the ACDIS Pocket Guide and CDI Pocket Guide, and…
Read MoreNew RADV rule coming soon; get your HCC compliance in order
The buzz is officially starting to build around the impending release of the Medicare Advantage Risk Adjustment Data Validation (RADV) final rule, which is expected to be published on or before Feb. 1 after years of delay. I hate to sound melodramatic (actually I don’t, healthcare reimbursement isn’t typically this dramatic and I need some…
Read More“You need to have a vision”: A conversation with Adelaide LaRosa, VP of HIM, CDI, EMPI, and DRG Appeals, Catholic Health
You’ll find few CDI/coding personalities as big and colorful as Adelaide LaRosa—and fewer still with a broader and bolder vision for what mid-revenue cycle professionals can do, and should do, to improve the quality and financial health of their organizations. Catholic Health’s VP of HIM, CDI, EMPI, and DRG Appeals reordered the entire heart of…
Read MoreFinal/updated ACDIS/AHIMA physician query practice brief is out: What does it say?
The final (revised/updated) ACDIS-AHIMA Guidelines for Achieving a Compliant Query Practice—2022 Update was released on Wednesday, Dec. 14th. What’s in it? If you’re a CDI or coding professional you need to read it. The link is below; the document is open source/free and available on the ACDIS website. A few items that jumped out at…
Read MoreACDIS/AHIMA release new query practice brief, are you ready?
By Brian Murphy The new ACDIS/AHIMA Guidelines for Achieving a Compliant Query Practice are out. Why care about this new guidance? The Guidelines are not law or regulation, but they are the standard that the two organizations recommend everyone follow. And that means literally everyone involved in the query process—CDI and coding of course, but…
Read MorePopulation Health: Eight Strategies for Success
By Brian Murphy Note: This is the second in a two-part series on how mid-revenue cycle professionals can successfully operate in population health. View part 1 here. Population health is the current buzzword in healthcare. But do you know how to succeed in these environments? Population health initiatives often stall due to silos within the…
Read MorePopulation health Q&A: Better Patient Outcomes at Lower Cost Requires Risk-Sharing
By Brian Murphy What is population health, this buzz-phrase we keep hearing about in the hospital mid-revenue cycle. And, why should we care about it? I sat down with Jason Jobes, Senior Vice President of Consulting for Norwood, to hammer out some high-level concepts including definitions, and why and how organizations enter into agreements with…
Read MoreCigna’s OIG Takedown a Thing of Beauty in an Ugly War
By Brian Murphy Many on the provider side of healthcare—including coding/billing/CDI/case management professionals—are not the biggest fans of Medicare Advantage (MA), aka, the semi-privatization of Medicare. MA has been under the spotlight recently for denying medically necessary care, as well as failing to demonstrate better outcomes despite charging higher premiums. But I have to hand…
Read MoreNorwood welcomes Jason Jobes, new Senior Vice President of Consulting
Norwood, a company specializing in staffing and consulting services to support the hospital mid-revenue cycle, is pleased to announce the hiring of Jason Jobes. In his role as Senior Vice President (SVP) of Consulting, Jobes will help to drive innovation and growth of Norwood’s consulting arm. Norwood’s consulting services seek to improve the efficiency of…
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