Hospital Case Management – October 1, 2013
October 1, 2013
View Issues
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Confusion ahead as CMS changes inpatient criteria
In the Inpatient Prospective Payment System final rule for 2014, the Centers for Medicare & Medicaid Services established a benchmark of two midnights for an inpatient admission and issued robust requirements for documentation. -
Documentation is the key to getting paid
Make sure record is complete -
Don’t think the auditors will go away
Chart review remains of utmost importance -
CMS focuses on quality, not quantity in IPPS
Hospitals stand to lose more reimbursement. -
Team focuses on needs of the elderly
Scottsdale Health System has seen a decrease in readmissions and emergency department visits among the elderly since the three-hospital system brought together all the community organizations and agencies to collaborate on improving transitions. -
ED observation unit targets 24-hour stays
Faced with denials for short stays and pressure to get patients out of the emergency department, Massachusetts General Hospital established an emergency department observation unit for patients whose stays are likely to be 24 hours or less. -
Leveraging resources improves care for seniors
Program cuts admissions, ED visits