Centers for Medicare and Medicaid Services

Initially, the recommended process will be presented during a one to one meeting with the Senior Vice President of Health Partner Services with the assistance of a power point presentation, supplemental handouts including the LACE index tool (Appendix A), as well as the proposed policy and procedure (Appendix E). The Senior Vice President of Health Partner Services…

Similarly, this crucial functional tool works tremendously for individual and communities as well, and an important function for any human services worker. Dealing with people can be laborious and daunting at times, as people are different, some are self motivators or get goers, while others would need to be guided and empowered, and this is where the skillful human service worker comes in. Participant empowerment is a technical term that many of us are familiar with, but…

national health care costs. Readmissions are the result of several difference aspects from incomplete treatment, poor post-acute care, lack of coordination in discharge planning, or even the unavailability of social supports. Recently the Center for Medicare and Medicaid (CMS) began penalizing hospitals for avoidable readmissions as part of the hospital readmission reduction program supported by the Affordable Care Act (ACA). Now that these penalties have become the “law of the land”, CMS is…

Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC) established three stages of the EHR Incentive Program. The three stages of Meaningful Use are designed to support eligible professionals and hospitals with implementing…

opinions to payments made to health care providers from Medicare and Medicaid in anticipation of improving care provided to patients. In 2012 the Centers for Medicare & Medicaid Services (CMS) made a change in the reimbursement rates by pooling a 1% accumulation of Medicare funds that have been withheld from hospitals payments; in order to pay qualifying hospitals bonus payouts. Qualifying hospitals can receive these bonus payouts from Medicare if they score above average on selected measures…

above the 95th percentile than it is obesity. This formula is just an indicator of body fat in children and teenagers. The prevalence of obesity for the age group of 2-19 is at 17% and within the past decade 12.7 million children and teenagers. The Centers for Disease Control and Prevention noted that the prevalence of obesity in 2011-2012 in the age group 2-5 was 8.4%. That same year 17.7% of 6-11-year-old were diagnosed as obese and 20.5% of 12-19 were obese. It was discovered that this…

health. Minors have the right to confidentiality regarding their sexual activity, orientation, birth control, and many other aspects of this type of healthcare. Without ensuring this confidential access, many minors would simply not seek any services for fear…

With the inception of the Patient Protection and Affordable Care Act (ACA) the Centers for Medicare & Medicaid Services (CMS) have really made even more of an effort to scale back on physician based Medicare/Medicaid fraud. These fraudulent cases come in all different manners from physicians and their practices knowingly defrauding the government to ongoing fraud which was never caught or knew they were committing fraud. Unfortunately CMS possesses little to no leniency for the infractions…

certain services for a particular fee. Without a standard, centralized health organization, individuals are left vulnerable to gaps in coverage and may be left with unexpected healthcare expenditures (Understanding healthcare in the U.S. 2021). Cost The United States spent roughly $4.5 trillion on health care in 2022, accounting for 17.3% of the Gross Domestic Product (GDP). To…

Cambridge University network is step-down cost system that allocates overhead to support cost centers and service cost centers. By considering cost drivers such as FTE’S, sq. footage, they calculate the rate for each cost center and then allocate the cost. This method, emphasizing on the amount charged for a procedure, provides the clear aggregate cost information in the unit of department or cost center and suitable for cost-based reimbursement system. However, the lack of emphasis on the…