2021 E&M Changes: Avoiding pitfalls with the right technology-enabled strategy

Posted in Client News Coverage on Tuesday, January 12, 2021.

As part of its goal to reduce administrative burdens on physicians, the Centers for Medicare and Medicaid Services (CMS) has introduced a final rule for Evaluation and Management (E&M) coding changes that go into effect in January 2021. Extensive revisions to the guidelines aim to minimize the amount of time physicians spend on documenting visits—prioritizing the documentation of information pertinent to patient care, creating resource-based reimbursement, and achieving less need for audits.

The move reflects a positive step forward in terms of patient care and administrative burden, yet documentation readiness hinges on a clear understanding of how the changes impact current practices. Rather than focusing on a checklist of conditions for reimbursement, documentation must prioritize a holistic view of patient care to align with the framework supporting E&M codes going forward.

Physicians Practise»

Keeping university and college micro-communities safe from COVID-19

Posted in Client News Coverage on Tuesday, January 12, 2021.

The COVID-19 pandemic has impacted global public health response in unprecedented ways, underscoring both shortfalls and the need for innovative solutions. For micro-communities like university and workplace settings, this reality is especially true.

When most college campuses reopened in fall of 2020, administrators spent the semester fluidly adjusting plans as dynamics around the virus changed. Now, as the U.S. turns the corner into 2021 and campus leaders reflect on the effectiveness of strategies, one area that consistently rises to the top of priorities is the need for good data—highly granular insights that inform optimal decision making within the confines of a college campus

University Business»

Why California Is One of the Worst COVID-19 Hot Spots and What the Future May Hold

Posted in Client News Coverage on Tuesday, January 12, 2021.

California, once a model of COVID-19 mitigation earlier in the pandemic, has seen its cases steadily rise throughout the summer, culminating in an ongoing crisis.

The state is now seeing case positivity rates of nearly 13 percent, with Los Angeles County seeing as many as 1 in 5 people test positive for the novel coronavirus.

Along with this comes reports of hospitals filling to capacity.

The scene is a severe version of a trend playing out across the country, as COVID-19 deaths nationwide have reached more than 367,000.


What are travelers afraid of in 2021? And what should they actually be worried about?

Posted in Client News Coverage on Friday, January 08, 2021.

Walt Meyer is afraid of getting sick when he travels. Too many people aren't taking COVID-19 seriously, he says.

He'd travel again this year if he could be sure that his fellow passengers were virus-free.

"If they could require everyone to arrive an hour early, get tested, then wait for test results before boarding a flight or entering a resort, it would eliminate some of the risks," says Meyer, an author and professional speaker from San Diego.

His fears are justified, say experts. COVID-19 will be the number-one travel concern of 2021, particularly during the first half of the year. But there are other concerns. The question is: What should travelers be afraid of?

USA Today»

Readers Write: Technology: An Essential Element of Holistic Revenue Integrity Strategies for Future Sustainability

Posted in Client News Coverage on Tuesday, January 05, 2021.

Healthcare organizations are facing a perfect storm of financial challenges. US hospitals and health systems entered 2020 with razor-thin operational margins that were exacerbated by substantial and ongoing losses related to COVID-19.

Amid a dramatic drop in healthcare spending during the first quarter of 2020, financial executives found themselves with limited means for countering ongoing pandemic-related impacts, touching everything from supply chain costs to lost billing opportunities and compliance issues. Notably, the industry acknowledges that federal incentives related to the COVID-19 pandemic will not provide enough relief to surmount the far-reaching financial impact.


Here are Arizona’s COVID-19 micro-hotspots

Posted in Client News Coverage on Friday, December 04, 2020.

Research from Arizona and beyond suggests the coronavirus that causes COVID-19 can spread erratically, making some infected people “superspreaders” and others dead ends for transmission. This can create clusters or COVID-19 micro-hotspots – neighborhoods, schools, towns or other small geographic areas where the virus runs rampant – even while communities next door remain relatively unscathed. These concentrated outbreaks aren’t included in the Arizona Department of Health Service’s COVID-19 data dashboard, which breaks down cases by county.

Dr. Peter Plantes, an internal medicine specialist, works with hc1, a health care data analysis company that recently launched a COVID-19 dashboard explaining the dynamics of the pandemic in new detail.

AZ Big Media»


Superspreaders, clusters and dead ends: Research reveals more about how coronavirus spreads

Posted in Client News Coverage on Thursday, December 03, 2020.

PHOENIX – Research from Arizona and beyond suggests the coronavirus that causes COVID-19 can spread erratically, making some infected people “superspreaders” and others dead ends for transmission.

This can create clusters or “micro-hotspots” – neighborhoods, schools, towns or other small geographic areas where the virus runs rampant – even while communities next door remain relatively unscathed. These concentrated outbreaks aren’t included in the Arizona Department of Health Service’s COVID-19 data dashboard, which breaks down cases by county.

Cronkite News/Arizona PBS»

Carrot Health, Colorado Hospital Association Analysis Identifies “Distinct Correlation” Between SDoH and Emergency Department Utilization, Hospital Readmissions

Posted in Press Releases on Monday, November 23, 2020.

Findings are part of a case study examining the relationship between SDoH and healthcare utilization in Colorado

MINNEAPOLIS – November 23, 2020 – A groundbreaking analysis by Carrot Health of claims data compiled by the Colorado Hospital Association (CHA) determined that a high Carrot Social Risk Grouper® (SRG) score correlates strongly with higher rates of emergency department (ED) super-utilization. The analysis, which combined data from CHA’s On Demand Hospital Information Network (ODHIN) with consumer behavior data from the Carrot MarketView® platform, also found that food insecurity and other underlying social factors were driving ED utilization and readmissions.

Hospital Sustainability Demands that Revenue Integrity Move Front and Center

Posted in Client News Coverage on Monday, November 23, 2020.

Razor-thin operational margins coupled with substantial and ongoing losses related to COVID-19 are culminating in a perfect storm of bottom-line issues for U.S. hospitals and health systems. A study commissioned by the American Hospital Association (AHA) found that the median hospital margin overall was just 3.5% pre-pandemic, and projected margins will stay in the red for at least half of the nation’s hospitals for the remainder of 2020.

HIT Consultant»

These Holiday Travel Errors Could Land You In The Hospital

Posted in Client News Coverage on Saturday, November 21, 2020.

Holiday travel is downright dangerous this year. Earlier this week, the CDC warned Americans to stay home this Thanksgiving. All across the country, people are scrapping their itineraries and making a U-turn.

And for good reason. Some holiday travel errors could land you in the hospital — or worse.

New COVID-19 cases shattering records, as my FORBES colleague Suzanne Kelleher recently noted. Many health experts are warning against all nonessential travel. But if you go — and I'm not saying you should — there are other errors you have to avoid. Because some holiday travel mistakes could kill you.



Revenue Integrity in the Era of Heightened Regulatory Scrutiny

Posted in Client News Coverage on Saturday, October 31, 2020.

The healthcare industry continues to see an uptick in oversight of federal healthcare payments. In late 2019, HHS’s Office of the Inspector General (OIG) reported that Medicare made $54.4 million in improper payments to acute care hospitals due to incorrectly coded claims. It also recommended that CMS direct its contractors to recover the lost money.

Enter 2020 and the introduction of COVID-19 incentive payments, and today’s C-Suite can expect a continuation of this trajectory in terms of increased scrutiny. In fact, the OIG recently announced its audit plans related to hospital payments covering COVID-19 discharges under the Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Healthcare Business Today»

Dr. Stephen K. Klasko Named Mainstage Keynote Speaker at hc1’s Precision Health Virtual Summit

Posted in Press Releases on Thursday, October 29, 2020.

Two-day virtual event scheduled for Nov. 17 and 18

INDIANAPOLIS — (October 29, 2020) hc1, the leader in critical insight, analytics, and solutions for precision health that power high-value health care, announced today that Stephen K. Klasko, MD, MBA, will be the keynote speaker during its Precision Health Virtual Summit scheduled for Tuesday, Nov. 17 and Wednesday, Nov. 18. This special two-day summit hosted by hc1 in partnership with Becker’s Healthcare will bring together healthcare leaders and experts to focus on the changes our care delivery system needs as it transitions from fee-for-service to value-based care reimbursement models.

Take Five Minutes Each Morning

Posted in News on Tuesday, October 20, 2020.

The Covid-19 pandemic has affected nearly every aspect of our lives today. Many of us now have new challenges that come with working from home, homeschooling, and sheltering in place. 

As a part of our series about how busy women leaders are addressing these new needs, I had the pleasure of interviewing Liz Goar, CEO of NPC Creative Services.

Thrive Global»


Readers Write: Who Remembers the Opioid Crisis?

Posted in Client News Coverage on Friday, October 02, 2020.

The last few years have ushered in significant progress on the opioid crisis containment front. Acknowledging decades-long misinformation shortfalls, negligence, and improper prescribing patterns, the healthcare industry took important steps on national and state levels to get out in front of devastating statistics.

A March 2020 report suggested the needle was finally pointing in the right direction. The Centers for Disease Control and Prevention (CDC) reported a 13.5% decrease in opioid overdose deaths from 2017 to 2018.

Unfortunately, that report was quickly overshadowed by the global pandemic that brought the nation to its knees. Opioid misuse, like many other critical healthcare priorities, took a back seat to COVID-19. The fallout is notable. A recent analysis points to a spike in opioid overdose cases by 18% since the start of the pandemic.


Taking Hold of the AI Opportunity in Revenue Integrity

Posted in Client News Coverage on Friday, September 25, 2020.

Health care is realizing the promise of artificial intelligence (AI) across a broad and seemingly endless range of use cases. The opportunities for using advanced technologies to accelerate labor-intensive processes touch everything from research and operations to supply chain and point-of-care decision making.

Data-hungry revenue integrity and billing compliance functions are no exception. AI tools such as machine learning, natural language search, and anomaly detection are fueling new and expanded insights into revenue integrity, billing compliance, and quality assurance to advance process improvement initiatives. And not surprisingly, the value proposition of these tools is growing rapidly amid COVID-19 as health care organizations try to maximize reimbursements against notable challenges such as revenue shortfalls and rapidly changing regulations.