Acknowledging that challenges remain, Human Services Secretary Sylvia Burwell argues that President Obama's administration has made progress in fixing the broken healthcare system, and she outlines four priorities for the immediate future.
Medicare Advantage (MA) plans are private health plans that have contracted with Medicare to receive a fixed monthly fee in exchange for providing comprehensive healthcare to plan members. In order to provide appropriate care to beneficiaries with varying medical conditions, plans are paid according to the Risk Adjustment Factor (RAF) score of each patient. Insufficient documentation of chronic conditions can be an obstacle to MA reimbursement. However, even when a condition has been properly documented by the provider, it is often not coded and submitted to Medicare. Read this white paper to learn how to take the complexity out of MA reimbursement.
When healthcare spending became a big concern, Jackson Labs turned to incentive-based screening and wellness programs, alongside other initiatives, to get control of the costs. And it's still working six years later.
Median numbers, important though they may be, tell only part of the story – and a slightly skewed one at that. Unless hospitals also gather statistics on the averages for each of these measures, they're probably seeing a rosier picture of their operations.