ICD-10 Implementation Dealine: Repeal of Omabacare and Affordable Care Act is a Separate Issue

ICD-10 implementations must move forward despite Presidential campaign promises to repeal 'Omabacare' or the Affordable Care Act. As Business Week pointed out this week, repealing the Accountable Care Act is not that easy. And even if it were repealed ICD-10 is a HIPAA mandate that was enacted prior to President Omaba's election in August 2008. Hospital systems should push ahead on ICD-10 Assessments, ICD-10 Implementation Plans, and get ready for the shift to ICD-10-CM which includes many more diagnosis codes than ICD-9. ICD-10 PCS also include many more procedure codes than ICD-9.

Continue ReadingICD-10 Implementation Dealine: Repeal of Omabacare and Affordable Care Act is a Separate Issue

Headline News in Healthcare is About Cost, Paperwork Reduction Rules Expected

This is a first step toward implementation of an Affordable Care Act provision that cuts red tape in the health care system. HHS estimates this will save $12 billion over ten years. Whether a patient is eligible for coverage The status of a health care claim submitted to a health insurer

Continue ReadingHeadline News in Healthcare is About Cost, Paperwork Reduction Rules Expected

Accountable Care Organization: New Risk in ACO Model vs. Prospective Payment System

To protect against this high risk of significant financial loss, the Accountable Care Organization should plan at its inception for methods of payment and/or protection for these cases, such as secondary coverage (insurance).

Continue ReadingAccountable Care Organization: New Risk in ACO Model vs. Prospective Payment System

Accountable Care Organizations and Medicaid

Accountable Care standards may be fluid for some time, however it is clear that there will be a need for core competencies in population management, coordination of care and other areas for an ACO to function effectively. Blum emphasized that CMS will be looking for innovative models, with different payment systems, and with different “on ramps” to formation and approval. It was also acknowledged that improving quality and reducing cost through coordination of care will at times be at odds with and the Accountable Care Act’s continued focus on patient choice of providers.

Continue ReadingAccountable Care Organizations and Medicaid