A study in Pennsylvania says that nonclinician “patient navigators” reduced nonemergency hospital emergency-room use by 43 percent and cut by 60 percent the 30-day readmissions for targeted diagnosis-related groups. This means that they can save hospitals a lot of money in new Medicare regulation fines.
Further, the study noted, the patient navigators for non-clinical tasks freed up more time to physicians and other clinicians to focus on tasks that more specifically required their medical expertise.
Herewith is some guidance on how to interpret and navigate the CMS’s final rebasing rules for home health agencies from Russel Krengel, a product manager for Kinnser. Of course, such agencies are becoming more and more important as outpatient services becoming more crucial as many hospitals shrink.
He writes:
“For the lucky, a detailed analysis reveals that the payment changes may actually come in the form of slight payment increases while many others may suffer payment declines of 5% or more. The question then becomes: Considering case mix volume, what is my 2015 reimbursement likely to be? More often than not, it won’t be the small reduction of 0.3% estimated by CMS.”
Research at the Max Planck Institute for Human Development in Berline found that medical students ”who worked in pairs to solve diagnostic problems were more likely to arrive at the correct diagnosis than those who worked alone,” MedPage Today reported.
”The research divided 88 research volunteers, all fourth-year medical students, into two groups. The first group of 28 worked individually, while the other 60 worked as pairs. Those who worked together arrived at the correct diagnosis 18 percent more often.”
This is good to know, but organizationally, it could often be difficult to arrange for such pairing with all the other duties of medical students.
The authors write that ”newly established CO-OPs may be unable to maintain liquidity, disperse risk, lower premiums, exercise leverage, and establish branded statewide integrated care models. Moreover, CO-OPs ‘too small to thrive’ may default on their loans.”
“Viewed in this light, the road ahead is clear in calling for aggressive recruitment of enrollees through competitive pricing and product diversification.”
“At this time, the future of the existing CO-OP program remains promising if uncertain,” the authors say.
In a New England Journal of Medicine piece, Perri Klass, M.D., talks of her anxiety, in looking after her now-late mother’s care in a hospital, as the weekends approach and so much of the hospital closed down, leaving patients vulnerable and family caregivers scared.
“I would start feeling tense every Thursday afternoon, every Friday morning, staving off panic by displaying a slightly frenetic need to get consults done, problems reassessed, orders written. I would waylay consultants, try to pin down residents about when they could come by and when they planned to sign out, press the nurses to page the attendings. I became one of those people I would have hated to encounter on a Friday afternoon….
….”I felt scared, as Thursday turned to Friday and the dark clouds gathered; I could feel the staff signing out, the hospital slowing down around us, and the weekend closing in.”
Will the understaffing on weekends of hospitals continue or even worsen with the Affordable Care Act and the flood of aging and ailingf Baby Boomers swells.
”But attorneys for two of the three former administrators on trial told jurors said underlings were to blame for the wrongdoing,” reported the Tribune.
The newspaper reported that ‘Federal authorities raided the hospital in 2013 amid bombshell allegations that doctors were performing medically unnecessary tracheotomies and giving heavy sedation to patients in a process called ‘snowing.’ At least five deaths at the hospital had been under scrutiny at one time, authorities said.”
”But when the indictment came six months later, none of the allegations involving patient deaths or oversedation was leveled against any of the defendants.”
”Prosecutors instead focused on kickbacks they allege were paid out on nearly every level to fill empty beds — with administrators doling out cash and gifts to physicians, ambulance companies, nursing homes and even van drivers. Physicians received kickbacks disguised as rent payments or teaching fees, according to prosecutors.”
