Index Admission / ReAdmission

While reading up on Resource Use Performance Category I had to get some clarification on the two types of admissions for understanding the scoring under Medicare Spending Per Beneficiary.   Index Admission: An index admission is an admission in a hospital with a principal diagnosis of a specified condition that meets the inclusion and exclusion […]

MACRA Resrouce Performance Category – Relationship to Physician Value-Modifier

Value Modifier utilizes 6 cost measures: Total Per capita costs for all attributed beneficiaries  (TOTAL PER CAPITA MEASURE) Total per capita costs for all attributed beneficiaries with (Chronic Obstructive Pulmonary Disease) COPD Total per capita costs for all attributed beneficiaries with (Congestive Heart Failure) CHF Total per capita costs for all attributed beneficiaries with (Coronary […]

Medicare Part A, B, C and D

Medicare Part A covers the following: Hospital care Skilled nursing facility care Nursing home care (as long as custodial care isn’t the only care you need) Hospice Home health services Medicare Part B covers 2 types of services Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that […]

Acronyms in MACRA

In preparation for my ongoing webinars on MACRA, while I started going through 1000 page MACRA document, I noticed several Acronyms and I thought is is helpful to have all of them in one place. ABC – Achievable benchmark of care ACA – The patient protection and affordable care act ACO – Accountable Care Organization APM […]

Understanding MACRA

One the big conversations now in Healthcare is the proposed MACRA, MIPS and APM models. MACRA proposes significant changes to the Payment models in Healthcare. In the next daily posts I plan to discuss MACRA and the proposed legislation in full.  My first post tomorrow will be a post on all the acronymns that come […]

Quality Improvement in Healthcare

The last few months or may be a few years the buzz word in HealthIT is Population Health or Quality Improvement. These words and acronyms mean different things to different people, however the main challenge in healthcare in general is ‘How to make your Patients Healthy while keeping the costs low?’.