Healthcare, Senior Living, Economics
Happy Eclipse Monday! The post title is meant as a bit of fun but there is a bit of relevancy as well. Billing fraud occurs via a process of hiding what actually has transpired (or should have) with the care of a patient. The most typical fraud is overbilling or charging the government for care … Read more
I’ve written a lot over the years about understanding the unique connection between quality care and the systems to support its delivery, and revenue. Arguably, the most successful provider organizations understand that impeccable quality of care (delivery, outcomes, patient satisfaction) begets high occupancy (referrals) and preferential payer mix (quality mix). Of course, the inverse relationship … Read more
A major concentration within my firm, H2 Healthcare, is compliance work. My wife heads this section of the practice, and she is widely known as one of (if not THE) the foremost post-acute/senior living experts on clinical quality, compliance, and risk mitigation/risk management. Her book on reducing survey risk for SNFs is still available on … Read more
In nearly all provider segments of health care, revenue maximization and integrity are directly tied to compliance and quality ratings. In home health, submission of quality data via the OASIS (known as HH CAHPS) is required. Agencies that fail to submit the required data experience reimbursement reductions of 2%. For SNFs, reporting of QRP data … Read more