ReleaseWire Connect

Health delivery systems and services integration has now been firmly establish by CMS in their most recent and final rule for Conditions of Participation in the Medicare and Medicaid programs. What does it mean? As explained by HSMN’s Chief Financial Officer, “essentially, that all eyes are focused on the patient and that services are delivered in a coherent and integrated fashion within the health delivery setting and across all of the health care delivery settings in a system”.

Enterprise-wide systems such as Epic are making invaluable contributions to a healthcare organization’s ability to have an EMR that allows a complete view of the patient and a comprehensive approach to claims management. One of the characteristics of this system and others like it, is that it is a frame whose internal work organization must be provided by the buyer. HSMN has assisted many organizations with the development of EMR criteria.

In the last decade, revenue cycle management has become the buzz word and inadvertently, the substitute for using critical thinking skills when it comes to the flow of revenue through the hospitals or physician practices. HSMN ensures that the integrity of the cycle is maintained and that all phases include optimization.

Hospitals and physicians practices must think about a comprehensive clinical documentation review with a view on education. Reimbursement by both the government and private insurers will continue to focus on how care is integrated and how that is reflected in clinical documentation. HSMN’s service helps hospitals and physicians with their clinical documentation practices.

ICD-10-CM implementation is moving forward despite the AMA’s objection; it supports a bill introduced last month by Republican Ted Poe (TX) that would block implementation of the new codes and requires a search for a less disruptive alternative code set. CMS maintains that ICD-10-CM is better organized than ICD-9-CM and logical, and therefore, will not postpone the implementation.