Case Management

Healthcare Case Management Article on Single Payer System

Posted on by Dominick Flarey

Good article for those interested in Healthcare Case Management.

The article, Single-payer would drastically change health care in America. Here’s how it works, by Kim Soffen states,

“As Republican efforts to repeal and replace the Affordable Care Act continue in the background, some Democrats are starting to eye a new health policy goal: implementing a single-payer system. Sen. Bernie Sanders (I-Vt.) introduced a single-payer bill in mid-September with 16 Democratic co-sponsors — 16 more than he got when he introduced the bill two years earlier. But how is the health-care system funded now, and how would “single-payer” change that?”

To read the entire article, please click here

If you would like to learn more about Healthcare Case Management or would like to become certified in Healthcare Case Management then please review our program and see if it matches your academic and professional needs.

Case Management Training Article On What Tech are the Coding Professionals Using Today?

Posted on by Dominick Flarey

Healthcare will always be an important part of society and a great provider of jobs. Millions of people seek medical care in hospitals every year. In recent years, there have been several developments in the health care industry, especially when it comes to technology. Hospitals are updating their billing systems, and healthcare facilities are using data support systems to supplement all the other kind of work they do. There are also several new technologies that make life easier for nurses, technicians and doctors. Here is a look at some of the newest tech being used by healthcare coders today.

 

Electronic Health Records

A few decades ago, medical billing systems were unorganized and unregulated. Today, medical facilities rely on electronic healthcare records. EHR software has changed the medical billing process. It has also reduced billing errors and made moderating between hospitals and insurance companies easier than ever. According to Integrity Support, their systems are used by a variety of types of healthcare facilities and centers and are followed by positive reviews wherever they are.

 

Changes to the ICD-9

Medical professionals have to keep a record of common and uncommon illnesses. Medical coders process thousands of claims every month. In 2015, the ICD-9 increased from 13,000 to 68,000 codes. Illnesses and treatments are assigned an alphanumeric code. Health care professionals are learning how to maintain security and analyze EHR data. This uniformity is making it easier for most processes to be integrated more fully and across systems.

 

Interoperability Between Health Systems

Value based health care is a necessity for medical professionals. Interoperability is an important part of the health care industry. Specialists and general practitioners need to communicate throughout a patient’s treatment process. Medical referral companies are helping doctors communicate, and the companies will be a large part of the health care industry in the near future.

 

Remote Patient Monitoring

Remote patient monitoring programs can collect a large amount of medical data. The data is sent to hospitals and nursing facilities. Health care professionals study the medical information, and the data becomes part of an effective treatment plan. Monitoring programs improve access to medical care, and the programs are cost-effective.

 

Medical Tricorder

A medical tricorder was the winning gadget at a global technology competition. It is used to record and review technical information. The device can diagnose diseases and record a patient’s vitals. It can also summarize a patient’s health status and monitor ongoing health data.

 

Digestible Sensors

Digestible sensors give healthcare professionals important information about their patients. The sensors can help doctors protect the patient’s organs. Eventually, digestible sensors will replace physicals. The sensors rely on the patient’s energy. When the data is collected, the information can be sent to a computer or mobile phone.

 

Healthcare technology continues to improve all aspects of the healthcare industry. Hardware and software developers are always introducing new applications and innovations and the changes will benefit patients and healthcare professionals.

 

Eileen O’Shanassy is a freelance writer and blogger based out of Flagstaff, AZ. She writes on a variety of topics and loves to research and write. She enjoys baking, biking, and kayaking. Check out her Twitter @eileenoshanassy.

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Healthcare Case Management Program Article on Risk Based Reimbursement

Posted on by Dominick Flarey

Good article for certified case managers or other healthcare professionals involved in health management executive positions

The article, Health systems see returns on risk-based reimbursement, by Alex Kacik states,

“In this year’s Modern Healthcare Hospital Systems Survey, only nine out of 60 respondents said they derived 10% or more of their net patient revenue in 2016 from risk-based contracts, which was largely in line with last year’s survey. Three-quarters of the respondents estimated that risk-based contracts generated 4% or less of their net patient revenue, but most indicated their share of risk-based contracts would slightly increase in 2017.”

To read the entire article, please click here

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Healthcare Case Management Article on Work Injuries and Healthcare Coverage

Posted on by Dominick Flarey

Injured on the Job? How Being Injured at Work can Impact Your Healthcare

Being injured on the job has the potential to seriously impact not only your physical health, but also your financial health and well-being. The good news is that state and federal workers’ compensation laws mean that there is a good chance your medical expenses will be covered. In addition, although approximately 75% of workers’ compensation cases only cover medical expenses, you may also be entitled to compensation for lost wages.

Unfortunately, while the workers’ compensation program provides many benefits to those injured on the job, it also has the potential to seriously affect the type and quality of the health care you receive. For this reason, it is essential that you know about the potential impacts to your health care in order to be fully prepared should you be unfortunate enough to experience a work-related injury.

Your Normal Health Insurance Won’t Cover Your Injury
Almost every health insurance policy contains an exclusion for work-related injuries, which means that your normal health insurance won’t cover any medical expenses related to treating injuries you suffered on the job. The reason behind this is that these expenses should instead be covered by your employer’s workers’ compensation insurance. However, your health insurance provider may still be required to pay for your medical expenses should the workers’ compensation insurance deny payment for whatever reason. Of course, it’s always a good idea to seek out workers’ comp lawyers in your area to ensure that your rights are respected.

You May Be Limited in Your Choice of Doctor
Not all doctors and hospitals accept workers’ compensation insurance, which means that you may be limited in your choice of doctors. If your current doctor does accept workers’ compensation insurance, you will still be able to use this doctor in most cases. However, should your doctor not accept workers’ comp, you will usually be forced to begin searching for medical professionals in your area that do take workers’ compensation cases.

You Could Be Forced to Wait for Treatment
Unfortunately, filing a workers’ compensation claim also means that you may be forced to wait longer before you can begin receiving any necessary treatments for your injury. The reason is that all medical expenses generally need to be approved by the workers’ compensation insurer before they can be performed. How this works is that first the doctor must determine whatever medical treatments are necessary to treat your injury. After this, the doctor then sends a request for authorization to the insurer, which then must determine that the treatment is necessary and reasonable before sending final approval back to the doctor. Although the process typically doesn’t take more than a few days, you will still have to wait to begin treatment until this final approval has been received.

American workers’ compensation laws were put in place in order to protect workers and ensure that their medical expenses are covered in case of a work-related injury. While this is definitely a huge benefit to anyone who would otherwise be unable to cover the costs of these medical expenses, it is still important that everyone is also aware of the ways in which a workers’ compensation claim can affect the health care you receive.

About the Author: Lizzie Weakley is a freelance writer from Columbus, Ohio. She went to college at The Ohio State University where she studied communications. In her free time, she enjoys the outdoors and long walks in the park with her 3-year-old husky Snowball.

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Case Management Certification Program Article on Small Practice Revenue Cycle

Posted on by Dominick Flarey

Good article for certified case managers.

The article, “3 Pain Points Affecting Small Practice Healthcare Revenue Cycle” by Jacqueline Belliveau states,

“While working in a small practice allows providers to really understand their patients and their community’s healthcare needs, it can also create unique healthcare revenue cycle management challenges.

Small practices come with several advantages. Some providers prefer the close relationship of working with just a couple other physicians versus a multitude of providers in a hospital.”

To read the entire article, please click here

Please also review our case management certification program to learn more.  Please review to see if it matches your academic and professional needs.

Healthcare Case Management Program Article on ER and Clinics

Posted on by Dominick Flarey

Good article regarding traditional ER’s and clinics.

The article, “The Lines Are Blurred Between Freestanding ERs and Urgent Care Centers”  by Olivia Nguyen states

“Last November in Frisco, Candie and Dustin Sandlin entered a Legacy ER & Urgent Care center—a walk-in clinic that also operates as a freestanding emergency center—because the couple’s primary-care physician was unavailable. Candie, experiencing symptoms of a migraine headache, was told by the on-site doctor that a CAT scan was needed to rule out any serious diagnoses.”

To read the entire article, please click here

If you are interested in Case Management and healthcare, then please review our healthcare case management program

Health Case Management Article on Technology and Patient Outcomes

Posted on by Dominick Flarey

How Innovative Technology Is Improving Patient Outcomes

Recently, healthcare had made some enormous progress. More compact and powerful hardware, along with increased competition and demand, has fueled intense research to bring us insights and tools that weren’t possible a generation ago. Here are just a few of the ways that technical innovation is creating more positive patient outcomes.

Wearables

Monitoring patient vitals has gone way beyond attaching wires and sensors directly to the skin. Today’s electronics allow medical sensors to be built right into hospital clothing, a technology that’s become known as fibertronics. The original concept had clothing such as shirts where traditional sensors were permanently attached to measure and transmit vitals like temperature, pulse, respiration, and even blood sugar levels.

With fibertronics, an array of tiny sensors and microchips can be wired right into hospital garb. This is hardly noticeable for the patient, and fibertronics actually provides more consistent and comprehensive information.

Telemedicine

The data that is provided by hospital sensors is taking the form of telemedicine. It can be uploaded to hospital computers anywhere in the world, where it’s analyzed by increasingly advanced algorithms that learn and adapt to patient trends. The results are instantly transmitted to viewable screens. Nursing staff can see essentially real-time reporting and react accordingly. Many systems can also provide visual and audio alerts if these readings fall outside safe thresholds.

This provides a level of visibility into the condition of ICU or incapacitated patients that is saving lives. Constant monitoring allows for more collaboration and better emergency management among nursing staff.

Bioprinting

The rapid evolvement of biologic materials that can be applied with 3D printing methods has opened the doors to astonishing possibilities for surgeons. While there is still some controversy surrounding the subject, laboratories can use stem cells to generate a sampling of the patient’s own cell types for a variety of applications. Today’s surgeons have already managed to recreate bones, arteries, skin, and even liver tissue to give those suffering from disease or traumatic injury new hope.

With bioprinting, doctors could recreate replacement parts to precise custom dimensions, so that even those born with birth defects may be able to lead normal lives.

AR and VR

Virtual reality has gone way beyond a video gamer’s paradise to helping improve medical outcomes. Surgeons faced with difficult procedures can review and practice them in virtual reality before cutting into the patient. Augmented reality adds something to the experience, such as providing important textual information to students using this technology to understand different treatments.

Patients about to undergo these procedures can also immerse themselves in VR to see for themselves exactly what will be happening. Viewing the entire procedure can give them a greater understanding and peace of mind. VR can also help them to understand and appreciate their own post-op obligations for ideal recovery.

Patient Education

Keeping patients educated and informed on their medical conditions and treatment is an important aspect of achieving the most successful outcomes and improving HCAHPS scores. Modern technology programs can automatically update patients on their own diagnosis, treatment, and recovery programs. Patients can read explanations and view video feeds related to their prognosis at every stage of the journey from examination to recovery.

Those undergoing treatment can interact with digital resources for viewing appointment and medication schedules, the identity and background of primary caregivers, dietary requirements, and even consult through video chat. Giving patients more information on their own condition and treatments will empower them to have a greater impact on their own recovery.

These are just a few of the emerging technologies that are providing healthcare professionals with superior tools and techniques. But helping patients to understand their own part in the healing process is also essential.

 

 

About the author: Anica is a professional content and copywriter from San Francisco, California. She loves dogs, the ocean, and anything outdoor-related. She was raised in a big family, so she’s used to putting things to a vote. Also, cartwheels are her specialty.

 

 

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Case Management Program Article on Data Breaches

Posted on by Dominick Flarey

HIPAA Headaches: What Happens When Patient Data is Compromised

 

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is legislation that outlines how health records must be protected and secured. However, in today’s technology advanced world, data breaches are occurring at an alarming rate and some of those breaches have compromised health records. Healthcare providers must understand how dangerous medical record breaches can be and what to do if they believe their data has been compromised.

Incidences of Medical Record Data Breaches

Over the past few years, 89 percent of healthcare organizations experienced a security breach. One reason hackers are particularly interested in health records is that they contain information that can lead to identity theft, such as social security numbers, home addresses and even the names of family members which are often used as security questions. It is expected that more than 25 million people will have their medical information stolen between 2015 and 2019. Breaches occur in many different ways. Some of the most common reasons for a breach in health records include:

  • Healthcare employee uses an unsecure cloud-based app to access protected health information
  • Excel spreadsheets with patient information copied and stolen
  • Missing backup disks from an unlocked storage facility
  • A weak password leads to a server breach
  • Doctors or administrators provide staff with usernames and passwords enabling an employee unauthorized access to data
  • The hacking of a server leading to the misappropriation of patient information

Healthcare Provider Responsibility Under HIPAA

All medical professionals, including doctors, nursing professionals, and technicians are required to safeguard patient records as much as possible. The 2009 stimulus act required that a breach that affects 500 or more patients must be reported to the Department of Health and Human Services as well as the media. One way that healthcare providers could provide added protection is to encrypt data, something that financial organizations have done for years, but something that healthcare providers have been slow to adopt. Other ways that medical records can be protected is by improved cloud storage and stricter password rules.

Increased Fines

One thing that the government is looking into to stop the increase in medical record breaches is an increase in fines against healthcare providers when data is breached. In many cases, the breaches occur due to lax security at the healthcare location. More than 40 percent involved portable devices like laptops or USB hard drives while a large number of other breaches occurred due to easily-hacked passwords. Since the enactment of HIPAA, there were more than 22,000 complaints about violations of privacy in medical records but only one fine has been issued since 2003.

It is critical that healthcare providers take as many steps as possible to protect the records of the patients they care for and there are steps that can be taken to that end. Encryption, stronger password requirements and secure cloud storage are three of the best ways you can keep your patient’s health records safe. Hopefully, the above information will help you, as a professional, to better secure your patients’ data.

 

Hannah Whittenly is a freelance writer and mother of two from Sacramento, CA. She enjoys kayaking and reading books by the lake.

 

 

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Healthcare Case Management Program Article on Healthcare Upgrades

Posted on by Dominick Flarey

Six Healthcare Upgrades Coming Soon to Your Clinic

Although many clinics are still behind the times, that’s all about to change. Advances in healthcare technologies and policies have forced administrators and owners across the nation to upgrade systems to meet growing demand. You can expect to soon benefit from the following healthcare upgrades in technology and clinic processes.

Electronic Health Records

Treatment and diagnosis, especially during emergencies, happen far more quickly when healthcare workers aren’t trying to sift through hard copy paper medical records to look for important patient details. With electronic health records, all health history is saved to a digital file that they can easily access, search, and share as needed.

Health Data Storage and Archiving

A wide variety of programs make it easier for healthcare personnel to access, search, and share your information. With a healthcare data storage company that provides a good program, your clinic’s staff members can use a simple keyword search tool to quickly locate important details about your health. With a health data archiving program, your clinic can securely store years of your data and won’t lose important information.

Online Health Maintenance

Online patient accounts help you to make certain that information is accurate and up-to-date, and give you access to appointment setting and reminder tools and communication options. Some clinics even offer online exams where nurses and doctors determine if patients are experiencing minor ailments or more serious problems that require on-site evaluation via video and VOIP.

Digital Signage and Touchscreens

Instead of providing important information about common conditions, new medications, and local and national healthcare news via brochures, fliers, and handouts, clinics can now provide these details and so much more while you wait via wall-based and kiosk digital signage. Touchscreens allow patients to print out details they want and check in electronically with a few finger taps or an ID barcode scanner.

Integrated Diagnosis and Treatment Systems

Changes in healthcare have also lead to more integrated systems. For example, during an outpatient procedure, a physician might utilize a new integrated treatment system to pull up your stored healthcare records to check symptoms or contact a colleague for assistance.

Physician-Focused Notation Tools

In recent years, physician note-taking tools have wasted a lot of time by forcing physicians to type too much or use long drop-down menus. New advances have resulted in a more comfortable and time-saving blend of software that converts handwritten notes to text and offers shorter drop-down options.

These are only a few of the amazing upgrades you can expect to see soon. Technology is always developing and has already changed many ways healthcare is carried out. From the diagnosis stage to recovery, medicine and technology always need to be top notch. Contact your clinic today for more information on new technologies and how to use some of the new processes and technologies.

Eileen O’Shanassy is a freelance writer and blogger based out of Flagstaff, AZ. She writes on a variety of topics and loves to research and write. She enjoys baking, biking, and kayaking. Check out her Twitter @eileenoshanassy.

 

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Where Your Healthcare Management is Failing and How to Fix it

Posted on by Dominick Flarey

Healthcare administrators often have difficult jobs, with their work environment constantly changing through new technologies and evolving practices. Fortunately, healthcare managers can make several improvements in their workplace setting as these changes take place. Here are some ideas to help healthcare professionals stay on top of changes in the industry.

Specialize for Growth
In the last decade, the number of specialty hospitals has increased. Many large cities have several diagnostic centers and outpatient surgery centers and patients have several options for where to go for treatment. Medical facilities must distinguish themselves from their competition and administrators must take into account the local demographics and the competing physicians specializations. When managers have identified their target population and their medical needs, the administrator can recruit qualified staff.

Prepare for the Future
Healthcare managers must also prepare for the future. The elderly population will need more medical care in the next few years and hospitals must meet the increased demand. In addition to keeping up with the growing demand, administrators must change the payment model. In the past, doctors were paid based on the services they provided. Now, the overall quality of care is an important factor in how payment is decided.

Patient Satisfaction
When payments are based on the overall quality of care, hospital managers have to make patient satisfaction a priority. Many administrators are conducting market research surveys. In large cities and rural areas, many hospitals are being renovated. Hospital managers want to make sure that the patient is always completely satisfied. Make changes when possible and necessary.

Technology and Patient Care
Technology is improving the current health care model and healthcare professionals are spending millions of dollars on electronic record keeping systems like EHR migrations. The technology gives doctors instant access to important information and federal requirements.

Affordable Health Services and Medicaid
In the last few years, many people have dealt with layoffs and the number of underinsured and uninsured Americans continues to increase. Currently, healthcare managers are dealing with financial challenges. Many patients cannot afford quality medical care. Healthcare managers must find the perfect balance between health care services and costs. The government has expanded Medicaid, and many nurse practitioners are opening low-cost medical offices.

Healthcare managers today must acclimate to changes that are occurring at the entry level and the managerial level. In the future, managers will need to implement measures that are above the status quo and will need to continue to focus on hygienic practices, health data archiver software, patient satisfaction, and affordable health care services.

 

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