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Foundations in Case Management: Medicare Reimbursement, Value-Based Purchasing, Bundled Payments and More
Recorded Webinar
This program will provide a foundation of knowledge and understanding of the DRG system used as the structure for reimbursement under the Medicare and Medicaid programs. Included in this will be a review of the DRG relative weights, case mix index and expected lengths of stay. Medical record coding will be explained in the context of how hospitals get reimbursed. This will be followed by a discussion of managed care and managed care contracting as well as the various managed care products currently on the market.
Also, included will be a discussion on bundled payments and what case management professionals need to know to assist their organizations in controlling cost and length of stay in a bundled payment environment where patients may access care and use resources at any touch point on the continuum.
A review of the state of the art in case management from both the acute care and community sides will also be discussed as well as the emerging trends that correlate directly with changes in health care reimbursement over time.
Venue: Recorded Webinar
Turn bad data into great data in minutes! Do you spend more time than is necessary importing and updating data from external sources such as databases, CSV files and web pages? Does the phrase "it's taking too long" describe how you feel about the time it takes to get your data into the right format for your reports? Do you regularly perform repetitive time-consuming "data cleaning and transforming" tasks such as removing unnecessary rows and columns, filtering out data that you don’t need, converting text to numbers or dates, splitting or merging columns, removing "weird" characters or combining files together? Would you like to be able to do all the above with the click of a button? If the answer Is yes, you need Power Query (known as Get and Transform in Excel 2016 and later). This training will focus on two main topics…How to import data into Excel from a variety of sources and how to automate the data cleaning process. Why you should attend Power Query / Get and Transform can save you a ton of time when working with imported data. In many cases when you get data from external sources, it needs work on it before it can be used. Although this can be done using Excel functionality, Power Query / Get and Transform is a lot faster and is repeatable with a couple of clicks. Topics covered Import data into Excel from sources such as text files, web pages and databases Avoid Excel’s "million-row limitation" Keep the imported data in sync with the source data using just two clicks Understanding and Managing Steps in the Power Query Editor Save a ton of time - automate the data cleaning process Who should attend? This training is classed as intermediate and is aimed at users of Excel who wish to learn about Power Query/Get and Transform to clean data (as both a one-off and a repeating process)
Confused about HIPAA compliance requirements and how it applies to your organization? HIPAA can be complicated!! Knowing what an organization must have in place to meet regulatory requirements can be challenging. For anyone tasked with managing a HIPAA compliance program, understanding the HIPAA security and privacy management process is critical to implementing and maintaining a comprehensive compliance program. The webinar will look at specific challenges organizations face in meeting HIPAA compliance requirements. This will include risk management plans; risk assessments; and program management. A growing concern with healthcare data is cybersecurity threats. The webinar will review critical HIPAA related information security topics. After completing this webinar, a Covered Entity or Business Associate will have a clear understanding for how to meet the growing demands of HIPAA compliance. Webinar Objectives Definitions, Rules, CFR, & Acronyms Who Must Comply with HIPAA Requirements? What are the HIPAA Security and Privacy Rules? Challenges of HIPAA Compliance What is a HIPAA Risk Management Plan? Upcoming changes to the HIPAA Privacy Rule How to prevent HIPAA data breaches from occurring Q&A Webinar Highlights Learn from an expert on the implementation of the HIPAA rules Learn what the HIPAA management process requires Learn how to uncomplicate and be able to evaluate your organization’s HIPAA compliance program Who Should Attend Compliance Officer HIPAA Privacy Officer HIPAA Security Officer Medical/Dental Office Managers Practice Managers Information Systems Manager Chief Information Officer General Counsel/lawyer Practice Management Consultants Any Business Associates that access protected health information
Every hospital that accepts Medicare and Medicaid reimbursement must follow the CMS (Center for Medicare and Medicaid Services) Conditions of Participation (CoPs) and it must be followed for all patients. This program will cover the nursing services section in the hospital CoP manual. Facilities with Deemed Status accredited by the Joint Commission, Health Care Facility Accreditation Program, CIHQ, and DNV Healthcare must also follow these regulations. There were some changes to the hospital nursing chapter of the conditions of participation (CoPs) in 2020. However, many of those changes are still awaiting interpretive guidelines and survey procedures. This program will discuss the often-cited areas of the CoP manual involving nursing care: plans of care, staffing, policy changes, when a RN is required in an outpatient department, documentation, supervision, nursing leadership, verbal orders, and more. Nursing services has been cited over 8,900 times according to the most recent report. Other changes in the past to the Nursing section include timing of medications, standing orders, plan of care, verbal orders, blood transfusions, IV medication, self-administration of medications and drug orders. This program will also reference the ever-changing non-discrimination regulations of Section 1557, and briefly mention other sections of the manual that impact Nursing and for which nurses should be aware. Objectives Recall that CMS has a section on nursing services that every hospital must follow even if accredited Describe the three different timeframes for which all medications must be administered Discuss that nursing care plans are a frequently cited area by CMS Recall the requirements for verbal orders Detailed Agenda Introduction into the CMS hospital CoPs manual CMS deficiency reports 2020 changes to Nursing section Recent memos affecting nursing Ligature risks Discharge Planning Non-Discrimination and Nursing Conditions of Participation - Nursing Nursing Services and 24-hour services RN on duty – recent update Organizational chart and nursing Chief Nursing Officer (CNO) responsibilities & requirements Staffing and delivery of care 24-hour nursing services and supervision RN to evaluate to care of all patients Nursing care plans Changes to the plan of care Assignment of patient care Agency nurse requirements Outpatient departments Medication administration Order required for all medications Requirements for complete drug order Medication safety and “5 Rights” Safe Injection practices Three medications timing changes Safe Opioid use Standing orders and protocols Verbal orders Blood transfusions and IV medications changes Reporting blood administration and medication errors Home and Self-administered medications CAH Nursing requirements Other manual section of importance to Nursing Restraint and seclusion Medication policies Visitation Discharge planning revised standards Appendix and Resources Who Should Attend? Chief nursing officer All nurses Nurse managers/supervisors Nurse educators Compliance officer Chief of medical staff Risk manager Patient Safety officer Senior leadership Joint Commission coordinator Regulatory officers Physicians
The Biden-Harris Administration, through the Office for Civil Rights (OCR) at the U.S. Department of Health & Human Services (HHS) has issued a Final Rule to modify the HIPAA Privacy Rule to support reproductive health care privacy. This Final Rule is one of many actions taken by HHS to protect access to and privacy of reproductive health care after the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization that has led to extreme state abortion bans and other restrictions on reproductive freedom in 21 states. To better protect information related to reproductive health care and to bolster patient-provider confidentiality, organizations providing these services will need to implement required changes. This webinar will review those changes and provide guidance on new HIPAA Privacy Rule requirements. Webinar Objectives Definitions, Rules, CFR, & Acronyms What is Protected Health Information? Understand the Prohibitions Understand the Presumptions Understand Attestation Requirements Needed Changes to Your Notice of Privacy Practices Understand Disclosures to Law Enforcement The Complaint Process Q&A Webinar Highlights Learn from an expert who has served as a HIPAA Compliance Officer in a large organization. Learn how to understand the HIPAA Privacy Rule Final Rule to Support Reproductive Health Care Privacy. Learn what PHI can be disclosed to whom. Who Should Attend Compliance Officer HIPAA Privacy Officer HIPAA Security Officer Practice Managers Information Systems Manager Chief Information Officer General Counsel/lawyer Practice Management Consultants Reproductive Health Providers Women’s Healthcare Providers Vendor Business Associates supporting these providers