The Journal of medical practice management : MPM最新文献

The Patient-Centered Medical Home (PCMH) represents a shift in how health-care is delivered as it shifts from reactive to proactive. A care transformation model with a number of studies demonstrating its effectiveness, PCMH can be a significant undertaking for primary care practices. This article presents a general overview of the PCMH model and briefly explains how it relates to the other healthcare reforms taking place.

Although meaicai practice managers often know a lot about how to reward individual employee performance, they may not be as well versed in the best strategies for rewarding teamwork. However, the most effective employee recognition and rewards programs focus on both individual and team performance. This article describes strategies that practice managers can use to reward teamwork without lessening their employees' desire to perform well individually. It describes five possible goals for a team rewards program and 10 practical tips for assessing and rewarding teamwork. This article also identifies three common concerns about rewarding teamwork and strategies for overcoming those concerns. It describes three types of team rewards programs and discusses when to use continuous and intermittent rewards. This article also offers medical practice managers a reliable five-question survey to use with their employees to assess teamwork and suggests a strategy to encourage employees to recognize the teamwork they observe in one another. Finally, this article explores the importance of the medical practice manager's attitude about team recognition and rewards and suggests what to do when the manager is conflicted about the team rewards he or she must give.

Alternative payment models (APMs) represent an unprecedented opportunity. for providers to have direct input into the terms of their own reimbursements for services provided. Understanding the rough boundaries of what comprises an APM is critical for those wishing to pursue possible involvement in APM devel- opment. This article attempts to provide structure to the plethora of CMS and other sources describing the principles guiding APM creation. Most importantly, as it is becoming increasingly apparent that APMs are a preferred method for. CMS to pay providers, organizations capable of leveraging stakeholder input and identifying methods to help meet the CMS Triple Aim via novel APMs will undoubtedly find themselves in much more powerful bargaining positions than those who simply adopt cookie-cutter approaches or, worse, fail to meet CMS goals and receive negative reimbursement adjustments through the Merit-based Incentive Payment System (MIPS) in 2019.

State licensing board investigations can subject a healthcare provider to serious discipline, up to and including license revocation. Providers can navigate these investigations by cooperating and complying with board directives, including self-reporting requirements. Additionally, state laws are designed to afford pro- viders due process rights before revoking or restricting a professional license, and these laws govern board investigations and the subsequent disciplinary proceedings. Providers should ensure that their due process rights are respected and that the board follows proper administrative procedures when their licen- sure is at stake. Further, providers should consider HIPAA, patient privilege, and medical records laws to guarantee that any patient information disclosed to a licensing board is disclosed in a legally compliant manner. Finally, special con- sideration should be given to providers impaired by substance abuse to ensure that they receive the treatment they need.

The healthcare industry is the #1 industry targeted by attackers. It is imperative for organizations to reevaluate the way they approach cybersecurity, rather than resting on their laurels in what is currently seen as the "new normal" security mindset. Currently, the industry is responding to compromises on a reactive basis, much like the way in which the financial services industry simply replaces consumers' credit cards after a retail breach, such as the recent attacks on Target and Home Depot. This security mindset is predicated on a lack of enforcement, the absence of appropriate penalties, and a culture of risk mitigation. Due to this attitude of acceptance, patients are consistently at risk of having their personally identifiable information compromised. To reset how healthcare organizations think about cybersecurity, measures must be taken proactively to protect busi- nesses against impending attacks. Otherwise, breaches are likely to continue until stricter enforcements and penalties are put in place for healthcare compa- nies and stakeholders.

Understanding the current selection of CMS-approved alternative payment models is critical for providers in the current healthcare policy climate who wish to pursue alternatives to traditional reimbursement schemes. This has become a topic of increasing interest with the recent passage of the Medicare Access and CHIP Reauthorization Act of 2015, as traditional fee-for-service payments will be altered-either positively or negatively-by criteria defined under the Merit-Based Incentive Payment System (MIPS). This article offers a framework for current and proposed models being implemented or investigated by the CMS. Further exploration of the topic can be carried out through supplementary or primary sources to determine best fits for specific practice environments.

The False Claims Act is a tool used by the government, its contractors, and even employees of healthcare providers to recover overpayments and other improper reimbursements given to physicians for healthcare services provided to Medicare and other federal health program beneficiaries. In recent years, we have seen an increase in the number of False Claims Act cases filed against unsuspecting healthcare providers and practices. These cases have resulted in billions of dollars being paid back to the federal government. Knowing and understanding the requirements of the False Claims Act and implementing best practices and strategies to avoid violating any of these provisions will help practices to ensure that they do not become subject to the massive penalties imposed on violators.

Women executives in healthcare have unique challenges to building strong professional networks. As in corporate settings, women in healthcare delivery systems often represent a large constituent group within the organization, but are only a small percentage of the organization's leadership pool. Male leaders often are identified as viable candidates for advancement through professional networks and invitations to participate in collegial networking opportunities. With this advancement may come higher earning power, autonomy, and author- ity. Since women continue to be underrepresented at the top of most corporate structures, it is imperative they be provided better opportunities to network, and be included in invitations extended to their male counterparts for company- sponsored networking activities.

The days of a practice putting up a shingle or sign and waiting for patients to come for treatment are over. The same applies to hospitals, which can't just have beds, an emergency department, an operating room, and an intensive care unit and hope to remain profitable in this tumultuous era of healthcare delivery. Now it is imperative to have a strategic plan to move forward. Practices and hospitals need a plan in order to prosper, rather than settle for mere survival. This article defines strategic planning, discusses the creation of a strategic plan, and lays out how a plan might be implemented in a medical practice or hospital.

This article examines the distribution of drug-based quality assurance events (QAEs) post-discharge across five-day increments and identifies characteristics associated with post-discharge QAEs. Data were obtained through a cross-sectional study of Medicare beneficiaries age 65 and over enrolled in stand-alone Part D plans during calendar year 2010. Our findings suggest an even more compressed timeframe than previously identified in the literature for addressing medication issues among elderly beneficiaries. Specifically, medication reconciliation is needed within two to three days of discharge instead of within 14 days as the literature suggests. To decrease inadvertent readmissions, an immediate in-community medication reconciliation following hospital discharge is needed.