Latest News in Healthcare

  • 17 Jun 2019 8:48 AM | Anonymous

    June 17, 2019

    Congress introduced the “Improving Seniors’ Timely Access to Care Act of 2019” (H.R. 3107), which establishes transparency requirements and requires electronic and real-time prior authorization within the Medicare Advantage (MA) program. 

    Click Here to Read More

  • 17 Jun 2019 8:38 AM | Anonymous

    June 17, 2019

    Physician business leaders are tasked with significant responsibilities to ensure their practice is poised to thrive and grow. When physician leaders take on these responsibilities, it is often assumed that these unfair assumptions can lead to tension, imposter syndrome and overwhelm.

    Carrie Koh, CEO and founder of Carrie Koh Consulting, recently joined MGMA senior editor Daniel Williams on the MGMA Insider podcast to talk about leadership communication, interpersonal efficiency, and what healthcare leaders can do to reach their potential.

    Click Here to Read More

  • 10 Jun 2019 8:49 AM | Anonymous

    June 10, 2019

    In a world of consolidation and acquisitions, verbal arrangements about physicians’ hours, duties and expectations matter a lot less than what’s written down on paper.

    A personal understanding between a doctor and chief executive officer about call duties or other elements of care goes out the window when a new owner comes in, cautioned Stephen A. Dickens, JD, FACMPE, vice president of medical practice services, SVMIC, at MGMA19 | The Financial Conference in Las Vegas.

    The changing landscape of ownership — along with shifting reimbursement models and a high number of physicians retiring or leaving the industry1 — makes it vital that a medical group’s leadership have a firm understanding of the elements of contracting and compensation for both employed and shareholder physicians.

    Click Here to Read More

  • 04 Jun 2019 12:55 PM | Anonymous

    June 4, 2019

    CBS Los Angeles reported that “burnout has been officially recognized as a medical issue by the World Health Organization (WHO).” Dr. David Angus, head of USC’s Ellison Institute for Transformative Medicine, stated that, additionally, “There’s now a code for burnout doctors can use to help patients improve their health.” Dr. Angus described this new code as giving doctors the ability to “‘make that diagnosis and bill the insurance company for it.’”

    CBS Los Angeles also described what exactly burnout is. WHO stated, “It’s a syndrome resulting from long-term stress that hasn’t been dealt with.” The symptoms of burnout can include exhaustion, being mentally distant from your job, and being unable to work effectively or productively.

    CBS Los Angeles outlined a few ways to create less burnout. For example, ER physician Anna Cheh, believes “‘If colleagues, employers and supervisors were kinder to each other, that would lead to less burnout.” Additionally, it’s important to take time away from work technology to be with friends and family.

    Want to learn more about culture and engagement? Click on this MGMA Stat

  • 28 May 2019 8:24 AM | Anonymous

    May 28, 2019

    MobiHealthNews outlined why new healthcare technology may not be designed with all types of people in mind. For example, “industry players have warned that many patient groups are being left behind—namely, people of color, underserved communities, members of the LGBTQ community and women.”

    MobiHealthNews stated that “‘frankly underserved communities of any color, are being left out of this conversation and the technology shifts.’” However, there has recently been a shift towards focusing on the social determinants of health that will hopefully bring more attention to those communities.

    Wildflower Health is an example of “a digital health platform that helps patients navigate benefits and connect to resources.” Wildflower also hopes to help “address women’s needs across a continuum of life,” not just throughout the common focus of pregnancy.
    New technologies as well as clinicians are causing bias, according to the article. However, there’s the possibility that “technology could have the opportunity to close some of this human bias.” Although, there is another thought that because “technology is designed, developed and fed data by humans” it could make biases worse.

    MobiHealthNews stated that the best way to start developing technology for all populations is to build a diverse team to work on the project.

    Want to learn more about business intelligence? Click on this MGMA Podcast.

Managing chronic care populations: Improve health & contain costs

April 29, 2019

Healthcare in the U.S. continues to move from volume-based care to value-based care. In the process, managing chronic disease has become both a universal imperative and a foundational element of a patient-focused population health program.

Leaders of many physician groups—including those partnered with multi-hospital systems—look for a solid, practical approach to chronic care management. Though difficult, practices are changing up their organizational structure to support alternative payment models that reward maintaining a healthy population.

This paper, a joint effort between Virence Health and Physicians Medical Center, PC, used a real-world example of how PMC introduced a successful population health program into its culture and, by doing so, made the shift to proactive, team-based care, allowing them to leverage their data and improve the lives of their patients.

Click Here to Read More

Three Environmental Factors Impacting the PPM Industry and Getting Deals Done

April 23, 2019

The PPM industry is by no means immune to the ebbs and flows of a traditional marketplace. Since the consolidation bubble burst in the 1990s, PPMs have gone from practically extinct to a once-again substantial component of the health care delivery system. But with greater influence comes more pressure to respond, and adapting to today’s complex operating environment requires those in the PPM industry to ensure they are building the foundational structure needed to help practices adapt to external factors and achieve long-term success.and achieve long-term success.

Click Here to Read More

Social determinants of health in an ACO for better population health

April 16, 2019

Valerie was a 31-year-old woman with uncontrolled diabetes, asthma, hypertension and was morbidly obese; she also had a history of trauma and depression. She increasingly was a no-show for appointments and would go to the emergency room instead of her primary care visits at Massachusetts General Hospital in Boston.

It wasn’t until Mass General implemented a social determinants of health (SDoH) survey that the providers learned that Valerie faced homelessness — until then, a P.O. box and a telephone number gave no indication of the larger issue in her life. They also learned that, despite being born and raised in Boston, Valerie could not read and write in English, her primary language.

Through SDoH work, Mass General staff were able to direct Valerie to emergency housing and ask what her goals were beyond health: Learning English, getting a job, securing an apartment and reuniting with her 3-year-old daughter, who was taken at birth due to Valerie being homeless.

As with most of us, social factors such as housing, education and a safe environment largely lead to better health outcomes.1 In Valerie’s case, her factors meant insufficient healthy food, lack of refrigeration for medication and issues with blood pressure heightened by living in a van and a lower sense of personal safety — all directly affecting the care providers working with Valerie.

Click Here to Read More

Nevada MGMA
PO Box 3403, Hamilton, NJ 08619