Wednesday, August 6, 2014

ICD-10 Transition Date Finalized for October 2015

The Centers for Medicare and Medicaid Services announced last week that the final deadline to comply with the ICD-10 implementation requirement is October 1, 2015. The tenth edition of the International Classification of Diseases is widely viewed as a significant change in the way claims that are submitted to Medicare and private insurance payers are classified. 

These changes enable providers to coordinate patients care over distance and time, improve the accuracy of patient records with more detailed patient history coding, and reduce fraudulent claims. CMS also believes that the ICD-10's granular classifications will improve the data and analytics related to public health research, surveillance, and reporting. The more specific classifications found in ICD-10 represent, in part, the evolution of diagnosis and the modern developments in medicine and medical technology used to treat patients. 

CMS released an online resource designed to help providers in small practices make a timely transition to ICD-10. The "Road to 10" is an online resource available here. The  Road to 10 breaks allows providers to select a profile based on their expertise that is specifically tailored to each speciality's common codes, clinical documentation procedures, and clinical scenarios. Additionally, the Road to 10 gives users the opportunity to create an ICD implementation action plan specifically suited to the needs of their small practices. 

Friday, July 25, 2014

NAHAM Requests Addition of Health Access Positions to Department of Labor's Standard Occupational Classification

The NAHAM Special Projects Committee recently submitted a request to the Department of Labor asking that the Standard Occupational Classification include health access managers and coordinators as distinct occupational classifications. NAHAM's Special Projects Committee worked hard to compile information on duties and responsibilities that are uniform across the health access field.

Politico reported on this letter in the "Morning Health" newsletter. Find their report below:


Seventeen health IT industry groups signed a letter to the Department of Labor this week requesting a new Standard Occupational Classification for the position of Health Informatics Practitioner. Presently, the classifications for health care lack codes associated with health informatics occupations. Due to lack of an official code, colleges and universities find it difficult to develop new academic programs, students in health informatics can't apply for federal aid, and health informatics practitioners can't fill in their correct occupational data on the U.S. Census, according to industry leaders. The HITECH Act of 2009 designated $118 million for workforce development, the letter points out, but new codes have not been created for all those jobs yet. "Collecting reliable and valid data for the health informatics occupation can be completed through the multiple discipline-specific professional associations and societies, but would be significantly improved with a [Standard Occupational Classification]," the groups write in the letter. Currently, they say, "there is a lack of appropriate career representation, both from work performed and a required education perspective." The letter writers include the Alliance of Nursing Informatics, the American Health Information Management Association, the American Medical Informatics Association and the College of Healthcare Information Management Executives, and various university, federal and state health informatics departments.

Monday, June 23, 2014

Medicare Expected to Release Final List of Hospitals Assessed with Penalties under Hospital-Acquired Condition Reduction Program in October

The Affordable Care Act established  three mandatory pay-for-performance programs. The three programs are the Hospital Readmissions Reduction Program, the Hospital Value-Based Purchasing Program, and the Hospital-Acquired Condition Reduction Program. Since the law was enacted hospitals have been scrambling to meet the requirements of all three programs to avoid the possible loss of 5.4 percent of Medicare payments if maximum penalties are assessed.

The Department of Health and Human Services estimates that one out of every eight patients suffered a potentially avoidable complication during a hospital stay in 2012. The Hospital-Acquired Condition Reduction Program was created as part of an effort to improve patient safety, create a financial incentive to improve care, and hold hospitals responsible for their negligence and dangerous conditions. 

Medicare will begin penalizing hospitals that have the highest rates of patients that acquire new infections or injuries during their hospital stay in October.  The preliminary list of approximately 750 hospitals Medicare expects to penalize was encompasses nearly a quarter of the nation's hospitals and is available here. Hospitals with the worst rates for hospital-acquired injuries and illnesses will lose 1 percent of every Medicare payment for the next year. 

Friday, June 13, 2014

Can't Miss NAHAM Webinar on Improvements to Patient Access Departments Through Automation, June 26th

NAHAM presents the "Building a More Efficient Patient Access Department Through Automation" webinar, free to NAHAM members on June 26, 2014, from 2:00-3:00 p.m. This webinar will be presented by Patrick Kelley, Dedicated Advisor at The Advisory Board Company, and Alexander Guambana, Senior Director at The Advisory Board Company.

In partnership with The Advisory Board Company and Lowell General Hospital, we will be walking through a health system’s response to new industry demands by leveraging automation and efficiency gains. The Advisory Board Company will present its research on new Patient Access trends across the industry, how patient estimation is becoming a major player in healthcare, and how hospital Revenue Cycle departments are responding to new legislation in the ACA. Join us as Lowell General Hospital and The Advisory Board present their experience of implementing a culture of point-of-service estimation and the utilization of technology.

Building a More Efficient Patient Access Department Through Automation

Thursday, June 26, 2014
2:00 pm - 3:00 p.m. ET

This webinar is worth 1 contact hour.

Click here to register for the webinar. There is no cost for members!

Upon purchase, you will receive information via email about accessing the live webinar.

Wednesday, May 7, 2014

Can't Miss Event May 13th at NAHAM 40th Annual Conference: NAHAM University Session

NAHAM University

 Hot Topics Discussion & Networking Opportunity

The National Association of Health Access Management 40th Annual Educational Conference & Exposition will be held May 13-16th in Hollywood, Florida. The conference theme this year is "From Admitting to Patient Access: 40 Years of Leadership." Conference attendees will enjoy outstanding educational sessions and invaluable networking opportunities. 

One of the most interactive and informative sessions is held before the conference officially begins on Tuesday, May 13th at noon. Peter Kraus, Business Analyst at Emory Healthcare, will moderate a NAHAM University session that is a popular venue for attendees to meet and discuss hot topics in the industry. 

The event is open to patient access manager participants from both academic and non-academic healthcare facilities. The topics for the 2-hour interactive session are determined by conference registrants. Kraus expects this year's discussion to cover the ICD-10 transition, Meaningful Use implementation, electronic health records, and issues that arise in the admission process. Participants found past discussions very helpful as colleagues offered road-tested solutions to the issues facing participants' individual hospitals.

What Hot Topics are you interested in? What issues is your hospital facing in 2014? 

Let NAHAM hear your topic suggestions for the the NAHAM University 
session in the comments section!

NAHAM University
Tuesday, May 13
12:00 p.m. – 2:30 p.m.
Separate registration fee applies. Lunch is included and will be provided starting at 11:30 a.m. 

Friday, May 2, 2014

Proposed Medicare Rule Leaves Hospitals Concerned About Financial Impact

The Centers for Medicare & Medicaid proposed a rule on Wednesday that makes changes to several aspects of the  Medicare payment program. The proposals were part of a wide-ranging, 1,600-plus-page proposed rule issued by the CMS outlining Medicare payment and policy changes for hospitals in 2015. A final rule is scheduled to be published August 1. The policies would be effective October 1.

Under the proposed rule the payments for inpatient treatment at acute-care hospitals will decrease by $241 million in fiscal year 2015. The proposed rule would affect over 3,000 hospitals nationwide.  In addition, the CMS proposes increasing Medicare payments to long-term-care hospitals by 0.8% in 2015, a bump of $44 million. The change in payment methodology would affect 435 facilities. Under the proposed payment rule, hospitals that successfully participate in Medicare’s quality reporting system and meet the criteria for the meaningful use of health information technology will see a payment bump of 1.3%. However, because of the penalties meted out to the hospitals that don’t, the CMS is projecting an overall reduction in payments.

Thursday, April 24, 2014

Notice to Patients Required for Outpatient Facility Fees

The Connecticut House of Representatives responded on Wednesday to medical billing concerns patients expressed over undisclosed and unexpected facility fees by unanimously passing a bill that requires notice. Many patients expressed that the additional charges were a surprise when they received their bill. The legislation now moves to the state Senate for a vote.

The charges, often referred to as "facility fees" are charged to patients by medical offices that are owned by hospitals for outpatient care. These fees are separate from doctor fees. Facility fees range from several hundred to thousands of dollars.

The bill to require notice to patients about fees possible extra charges for outpatient care at medical offices owned by hospitals. The bill specifically requires that patients with scheduled appointments at medical offices where facility fees are charged receive notice about the fees in plain language before they receive treatments scheduled so long as the appointment is scheduled at least 10 days in advance. If the exact nature of the services or insurance coverage is unknown the patients would be provided with an estimate based on typical charges at the facility. Notice for patients receiving emergency care would need to be delivered as soon as practicable after the patient is stabilized. The bill does not impact the offices' ability to charge facility fees.

Other provisions in the bill are include requirements that the office prominently displays that the facility is connected to a hospital, what hospital the office is affiliated with, and states that the patient may be incur higher charges than if they were treated at a facility that isn't hospital-based.