Category: Blog

how-5-steps-transforming-patient-access-saved-20m

How 5 Steps For Transforming Patient Access Saved $20M

  ‘If you can get it right up front, you’re ensuring accuracy, preventing rework, and preventing denials,’ says Alicia Auman, director of patient access at KSB Hospital. Patient access plays a tremendously important role within the revenue cycle, which is why Alicia Auman, director of patient access at KSB Hospital in Dixon, Illinois, has worked […]
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the-impact-of-coding-on-maternal-outcomes-part-ii

The Impact of Coding on Maternal Outcomes: Part II

Coding blood transfusions on maternity patients saves lives. If you are a “frontline” coder buried in the minutiae of day-to-day coding, discussions about quality initiatives may not be in the forefront of your brain. We often hear of the importance of these programs in improving patient outcomes, and how critical “accurate and consistent” coding is. […]
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aha-calls-for-medicare-advantage-inclusion-in-prior-authorization-rule

AHA Calls for Medicare Advantage Inclusion in Prior Authorization Rule

The American Hospital Association (AHA) has asked CMS to include Medicare Advantage organizations in its proposed rule that would streamline the prior authorization process and reduce patient care delays. In December 2020, CMS released a notice of proposed rulemaking about improving prior authorization, following past administrative and clinician struggles. If the rule is finalized, there […]
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2022-medicare-advantage-plan-overview-part-three-social-determinants

2022 Medicare Advantage Plan Overview, Part Three: Social Determinants

  “Medicare Advantage plans have a unique and growing opportunity to address the needs of socioeconomically vulnerable populations and improve their health,” reports America’s Health Insurance Plans. More plans for individuals with low incomes, as well as targeted SDOH investments and initiatives, round out carrier approaches. On the benefits side, offerings such as meals, transportation, […]
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More Medicare Advantage plans will offer nonmedical benefits in 2022, finds Avalere

  More plans will offer meals, nutrition, transportation or in-home support services at a $0 premium in 2022. Ahead of the annual election period, which began on October 15, the Centers for Medicare and Medicaid Services published information on MA and Part D plan (PDP) premiums, benefit offerings and star ratings. Avalere analyzed that data […]
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the-impact-of-coding-on-maternal-outcomes

The Impact of Coding on Maternal Outcomes

While most maternal deaths are preventable, the rate has been increasing in the United States since 2000. As a matter of fact, the U.S. has twice as many maternal deaths than other high-income countries. To reverse this trend, The Joint Commission, the Centers for Medicare & Medicaid Services (CMS), and the Agency for Healthcare Research […]
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Most Medicare beneficiaries don’t compare coverage options during open enrollment

Since not shopping around can have an impact on enrollees’ coverage and costs, CMS recommends they review and compare plans each year. The numbers are similar across both Medicare Advantage and traditional Medicare, with 68% of MA beneficiaries saying they don’t compare medical plans, and 73% of those in traditional Medicare claiming the same. The […]
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2022-medicare-advantage-plan-overview-part-two-portfolio-strategy-and-leading-carriers

2022 Medicare Advantage Plan Overview, Part Two: Portfolio Strategy And Leading Carriers

  The ideal value chain for any industry or company is one built for lifelong customer retention and loyalty. One component of such a chain is a portfolio strategy that continues to offer maximum choice and affordability. For insurers in the Medicare market, this equates to a mix of plan designs and standalone prescription drug […]
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