News
Article
CMS
Hospital Management
Medicare
Physician Advisory
Dr. Ronald HirschFebruary 20, 2020
New Technology: Price it Right, or Else
There is nothing wrong with adjusting prices to fit your cost-to-charge ratio. New technologies have always posed a financial challenge to hospitals. While they want to provide cutting-edge care to patients, unless a positive margin can be maintained, the costs of those technologies can quickly lead to ...
Article
CMS
Hospital Management
Dr. Ronald HirschJanuary 16, 2020
The Dilemma of the Discharge Planning Conditions of Participation
It was way back in 2015 when the Centers for Medicare & Medicaid Services (CMS) proposed changes to the discharge planning conditions of participation. Their goal was noble; they understood that because discharge planning is a complex process, a successful discharge plan is crucial to reducing the risk of ...
Article
CMS
Hospital Management
Physician Advisory
Angie StewartJuly 19, 2019
Outmigration of Cardiology - Logistical Challenges for ASCS + How Hospitals are Bracing for Volume Loss
CMS' 2019 Outpatient Prospective Payment System rule cleared the way for some cardiac procedures to be performed in ASCs, creating financial uncertainty for hospitals, according to Ronald Hirsch, MD, vice president of regulations and education group for R1 RCM.
Article
Hospital Management
Medicare
Physician Advisory
Dr. Ronald HirschJune 20, 2019
Physician Practice Audit Targets Now Become Hospital and Health System Compliance Risks
Twenty four percent of the federal budget was spent on Medicare and Medicaid in 2017.
The Medicare Trust Fund is forecast to be depleted in 2026. Over 8% of Medicare fee-for-service payments in 2017 were made in error. These factors have all led Congress to put more ...
Article
Hospital Management
Revenue Cycle
Ayla EllisonMay 16, 2019
Hospital Executives Identify the Top 3 Challenges to Revenue Cycle Transformation
Hospitals and health systems are exploring ways to transform revenue cycle processes to offset financial pressures. However, shifting to a new business model for revenue cycle management can be challenging.
Article
CMS
Hospital Management
Physician Advisory
Dr. Ronald HirschMarch 20, 2019
OIG Audits Part A SNF Stays for Qualifying Inpatient Admissions - And the Results are Not Pretty
The federal watchdog did not, however, decide to demand recoupments.
It is said that great minds think alike. And that proved to be true when the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) released its report (CMS improperly paid ...
Article
CMS
Hospital Management
Physician Advisory
Dr. Ronald Hirsch for HFMA’s First Illinois Chapter NewsletterMarch 13, 2019
Future of Hospital Cardiac Programs in Flux - $700,000,000 At Stake
Much of the talk in the last few months has been about the changes proposed by the Centers for Medicare & Medicaid Services (CMS) to the physician evaluation and management code selection and payment regulations in the 2019 Proposed Physician Fee Schedule Rule. And there was a collective national sigh of ...
Article
Hospital Management
Physician Advisory
Revenue Cycle
Becker's Hospital ReviewJune 16, 2017
10 Ways Hospitals Can Improve Charge Capture
Charge capture is a crucial part of the revenue cycle process, as healthcare organizations that fail to accurately document information on the care provided at their facilities can potentially lose millions in revenue.
Blog Post
CMS
Hospital Management
Medicare
Mary Lou WedenSeptember 15, 2016
Why Do Hospitals Get Accredited by The Joint Commission?
Why accreditation? Quite simply, hospitals pursue accreditation because it is required in order for their organizations to receive payment from federally funded Medicare and Medicaid programs. Once a healthcare organization achieves accreditation through The Joint ...
Blog Post
CMS
Hospital Management
Medicare
Mary Lou WedenMay 29, 2015
The Joint Commission vs. CMS Requirements: What’s the difference?
The Centers for Medicare and Medicaid Services (CMS) and The Joint Commission are bodies designed to ensure compliance with federal regulatory standards for hospitals. The goal of these programs is to ensure quality care and patient safety. By complying with the standards set by the organizations, there is ...
