MCO execs should be looking at payment changes that are win-win for the payer, consumer
2009 sure to be a year of quick changes
CMS is sending a message that all prescribers must begin using electronic tools to increase safety and reduce costs. Commerical payers are onboard.
The proposed transition to ICD-10 and HIPAA 5010 will lead to chaos, fraud, abuse and consumer dissatisfaction because the current timeline is unworkable
The World Health Organization's latest version of the International Classification of Diseases and Related Health Problems (ICD) will bring "the good, the bad, and the ugly" for nearly all who use this classification system. However, the biggest asset is that the latest version is much more detailed and organized than ICD-9.
With the increasing trend toward consumer-directed healthcare, providers can add another specialty to their list: bill collector.
Surgical site infections are a significant problem in hospitals today. They occur in 2% to 5% of patients who have clean operations outside the abdomen, and in up to 20% of patients with intra-abdominal procedures. They account for about 15% of hospital-acquired infections.
With Administrative costs accounting for as much as 40% of all healthcare dollars spent, many states are seeking new and innovative ways to eliminate bureaucracy and red tape. One area receiving more attention is the resolution of billing disputes between providers and payers. In 2006, New Jersey and California implemented arbitration programs to resolve the growing aggregation of healthcare payment disputes.