MLR

Category: Healthcare

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The cost of medical malpractice continues to rise, according to the Aon/American Society for Healthcare Risk Management (ASHRM) Hospital and Physician Professional Liability 2013 Benchmark Analysis. This annual study helps health care providers better understand trends related to medical malpractice risks. It also provides benchmarks for hospitals and physicians to compare to their own claims histories.

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In the wake of health care reform, you might find your practice inundated with new patients. With the extra workload, you might want to hire one or more physicians to help out.

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Improved contact between physicians and their patients — known as “etiquette-based communications” — would improve the “inpatient experience” and could help a patient recover more quickly, a randomized trial found.

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It turns out that keeping patients in the hospital for just one day longer can saves lives, lower costs and reduce readmissions. That’s the conclusion of one study from the Columbia University Business School entitled “Should Hospitals Keep Their Patients Longer?”

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Nearly every physician has claims denied from time to time. Medicare, as a government program, has its own way of doing things. As you know, the process is different from insurance companies, which also have their own way of handling claims.

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The bane of every physician’s practice is when payers deny claims. There are numerous reasons why payers deny claims, with the predominant reason being a paperwork error. Other reasons include misunderstanding on the part of the insurance company, the physician or the patient. There are four key elements in appealing claims that have been denied.

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If there’s one thing that can harm the success of a medical practice, it’s having patients spending too much time in the waiting room.

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Practicing medicine today is increasingly challenging, and the pace of change isn’t getting any slower. To stay viable, practices have to face the challenges head on and develop strategies to thrive in a value-based payment environment. A new provides materials to meet these challenges.

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The Centers for Medicare & Medicaid Services has modified the Medicare Shared Savings Program to increase participation in accountable care organizations.The program is designed with several tracks. Track 1 is risk free. Track 2 participants share in both potential savings and losses. The new rule adds flexibility, updates benchmarks and adds a third track offering greater reward in relation to greater risk. (11/9/2015)

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It’s full steam ahead in the Department of Health and Human Services’ effort to increase participation in accountable care organizations and use financial incentives and quality metrics to determine how providers are paid. (10/26/2015)