The provider community has been begging for documentation reform for over 20 years, and there is no question that simplifying the complex requirements of clinical documentation is necessary. Unfortunately, the recent release of the proposed changes from CMS surrounding evaluation and management (E/M) is not the answer. The benefits of the modest reduction in documentation requirements are more than offset by the devastating impact the changes will have operationally, clinically, and financially.
Hayes' Healthcare Blog
In last week’s post, Lisa English described the growing importance of healthcare analytics in dealing with large-scale initiatives like population health. She also outlined the important role analytics can play in solving the day-to-day problems of monitoring risk areas, supporting continuous risk assessment, and complementing limited compliance resources that organizations face every day.
In spite of the increased reliance on analytics, Lisa stressed that there is still much we need to learn. She outlined four things about analytics that might surprise you. Here are four more considerations surrounding analytics that you may not have realized.
Yes, the terms “big data” and “analytics” are buzzwords, but they clearly highlight a shift toward data-driven decision-making with a real measurable impact on outcomes in many different industries. Savvy digital marketers now mine your digital breadcrumb trail to offer you more of what you like and attempt to discern what you need before you are aware of it yourself. This not only drives sales, but also actually helps consumers - if they aren’t “creeped out” by the “Big Brother is watching” when you post on social media then immediately see ads pick up on a word from your post.
In the healthcare industry, the move to population health is just one obvious application for sophisticated analytics. As we appropriately engage our best and brightest in solving the core healthcare issues of our society, we find the key questions that analytics can help answer: What treatments drive positive health outcomes for patients? How can we curb wasteful, ineffective healthcare? Ultimately, why does the US spend more on healthcare than all developed nations while getting only mediocre healthcare outcomes when looking at our population as a whole?
Authors: Carrie Walters-Derksen and Susan Horahan
In a recent survey of Chief Audit Executives, an increased focus on risk management was named the top initiative by 60% of respondents. The continuing growth of regulatory compliance demands in the healthcare industry – and the heightened risk that comes with it - is placing an enormous strain on auditing resources in most organizations. Deploying those resources in the most effective way means narrowing audit focus to those areas that pose the greatest risks.
The growing adoption of this type of approach explains why risk-based auditing is such a hot topic in healthcare circles today. With only so much time available for auditing, it’s critical for organizations to target specific areas of interest and not devote time to areas with little or no significant impact. Moving from an annual risk assessment program to a risk-based audit plan can be one of the most important moves a healthcare organization can make.