All Articles In 'Medicaid'
Hospitalizations for Mental Health and Substance Abuse Disorders: Costs, Length of Stay, Patient Mix, and Payor Mix
New data from AHRQ highlight inpatient hospitalizations for mental health and substance abuse disorders, including costs, length of stay, and payor mix. Overall, the AHRQ statistics show interesting differences between inpatient stays for mental health, substance [...]
Using Health Information Technology for Chronic Disease Management: AHRQ Webinar
The Agency for Healthcare Research and Quality (AHRQ) is hosting a free webinar on Using Health Information Technology for Chronic Disease Management. Webinar is set for Tuesday, June 21, 2011, at 11:30 am EST. During the 90-minute conference, participants can watch [...]
Medicare and Medicaid Compliance: OIG Advice for Operating an Effective Compliance Program
Comprehensive compliance programs are essential for all hospitals, health systems, physician practices, Medicare Advantage plans, Medicaid health plans, Medicare prescription drug plans, drug manufacturers, medical device makers, long-term care providers, and others doing business with Medicare, Medicaid, or [...]
Compliance Challenges of Health Reform: Questions Compliance Professionals Should Ask as They Prepare for Health Care Reform
With an array of payment reforms, quality and safety requirements, massive expansion of Medicaid, and creation of the new State Health Benefit Exchange marketplace, the Affordable Care Act (ACA) presents extraordinary new challenges for compliance, especially [...]
Hospital Readmissions: Data on Hospital Readmission Rates for Medicare, Medicaid, Privately Insured, and Uninsured Patients
Hospital readmission rates are receiving increasing attention by Medicare, Medicaid, and private health plans. Research shows that a high proportion of hospital readmissions are preventable. Most hospital payment methods, most notably the Medicare Part A inpatient [...]
Medicaid Fraud and Abuse: Investigations, Prosecutions, Spending, and Staffing by State Medicaid Fraud Control Units in 2010
Nearly every State has a Medicaid Fraud Control Unit (MFCU) to investigate and prosecute cases of Medicaid fraud and patient abuse and neglect. MFCUs are a key part of an array of federal and state agencies combating [...]
Primary Care Physicians and Hospital Emergency Departments: Improving Communications
Hospital and emergency room utilization is expected to increase substantially when 35-40 million Americans become newly insured through Medicaid and State Health Exchanges starting in 2014. Today, communication between primary care physicians and hospital emergency departments is [...]
Electronic Health Records: Medicare and Medicaid EHR Incentive Payments for Hospitals and Physicians
Medicare and Medicaid payment incentives are available for hospitals, physicians, and certain other healthcare professionals that implement and use Electronic Health Record (EHR) systems. To receive the payment incentives, eligible providers must engage in meaningful use [...]
Medicare and Medicaid Fraud: Voluntary Self-Disclosure of Potential Fraud by Hospitals, Physicians, and Other Providers
Medicare and Medicaid program integrity efforts – coupled with complex coding and claiming procedures, ever-increasing program requirements, new payment methods, and the growing market share of taxpayer-funded programs – present significant compliance challenges for health plans, hospitals, [...]
Centers for Medicare and Medicaid Services Plans to Modernize Business Processes, Technology, and Data Used to Manage Medicare, Medicaid, and Health Reform
The Centers for Medicare and Medicaid Services (CMS) plans to contract with an organization to help CMS modernize the business processes, information technology, data, and planning and analytical capabilities used to manage Medicare, Medicaid, and health [...]
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