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The Centers for Medicare & Medicaid Services (CMS) is adding new metrics to its Value-based Purchasing Program each year, and case managers should look ahead to ensure that their hospital performs well on the measures.
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The Inpatient Prospective Payment System proposed rule for fiscal 2015 continues the Centers for Medicare & Medicaid Services move toward basing reimbursement on quality of care, not quantity.
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At MedStar Franklin Square Medical Center in Baltimore, discharges are facilitated by a multidisciplinary transitional care team, led by a transitional care nurse who fosters communication between disciplines and collaborates with post-acute providers to ensure that transitions are smooth and timely.
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Hospital efficiency of care, a new domain in the Centers for Medicare & Medicaid Services Value-based Purchasing Program, bases hospital scores on spending three days before admission through 30 days after discharge.
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If discharge documentation isnt complete and accurate, coders may not use the correct discharge status code, which could affect a hospitals reimbursement.
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