GI Alliance’s Post

Clinically Integrated Networks Increase the Revenue Per Visit Single specialty Clinically Integrated Networks – (CIN) increase the revenue per patient visit without disrupting existing attractive payor contracts. Successful CINs add a value component to existing contracts. The key is to demonstrate to payors that the CIN improves clinical outcomes while reducing costs. These successful CINs: Develop network wide protocols to manage high-cost diagnoses.  Focus on early detection and treatment.  Exclude high-cost providers with poor clinical outcomes.  Provide access to profitable direct employer contracts. To learn more about developing successful Clinically Integrated Networks - click on Lumina Heath Partners at https://lnkd.in/gHQnRaVi

OBFA is asking Congress to pass the Promoting Fairness for Medicare Providers Act of 2024 (H.R.10136) to protect independent physicians providing office-based interventional healthcare.   CLICK on link Below THE BACKGROUND: H.R. 10136 would provide immediate and permanent reimbursement stability for office-based interventional services that utilize high-cost supplies over $500 by establishing a new “office-based facility” site-of-service. Reimbursement for specified surgical procedures with high-cost supplies would be paid at 90% of ambulatory surgical center (ASC) rates, thereby helping to stop further closures of centers that provide office-based interventional care.      ACT NOW: This newly introduced legislation is bipartisan and can pass if providers across the country contact their members of Congress. Follow this link to tell your U.S. Representative to support H.R. 10136. https://lnkd.in/d-J6wQCX

Integrating Utilization Review (UR) and Clinical Documentation Improvement (CDI) can significantly reduce physician disruptions, fostering a more collaborative and streamlined approach to patient care. Strategies for integration include: Implementing Interdisciplinary Teams: Create teams that include UR and CDI specialists, physicians, nurses, and other healthcare professionals to facilitate communication and collaboration. This promotes a unified approach to patient care and documentation. Enhancing Communication Channels: Establish clear, efficient communication channels between UR, CDI teams, and physicians. Regular meetings, shared electronic platforms, and real-time alerts can help address issues promptly without significantly disrupting physician workflows. Providing Education and Training: Offer ongoing education and training for physicians on the importance of UR and CDI processes, emphasizing how these efforts can enhance patient care outcomes and financial health for the institution. Streamlining Processes: Continuously review and refine UR and CDI processes to minimize redundancy and ensure that physicians are only involved when necessary. Simplifying the documentation process can also help physicians focus more on patient care. Encouraging Physician Leadership: Involve physicians in the leadership of UR and CDI initiatives. Physician champions can advocate for integrating these functions, highlighting their benefits and addressing any concerns from a clinical perspective. By implementing these strategies, healthcare organizations can enhance the synergy between UR and CDI, leading to improved documentation, more efficient patient care processes, and reduced physician disruptions. For more insights into integrating UR and CDI for a more collaborative patient care approach, visit our website. https://lnkd.in/g5xDz3fs

CDI GOLD - LIVE - Medical Necessity- It is not just a CM/UR thing! Description In case you missed this month's CDI Gold show, here is your chance to listen to the recorded version where ERNIE DE LOS SANTOS and I discuss the role of CDI in working with physicians, Physician Advisors, and Case Management/Utilization Review to drive and achieve sustainable physician documentation excellence proactively with fewer queries. After all, what physician wants more queries in their email box. CDI needs to work with Physicians, CM/UR, Physicians, and Physician Advisors to drive better documentation using a team-based approach... so we will review how to do that! CDI GOLD LIVE - A ROUNDTABLE FOR CDI SPECIALISTS & THOSE WHO PURSUE EXCELLENCE #CDIexcellence, #Teambasedapproach, #fewerqueries, #medicalnecessity, #denialsavoidance. #Betterdocumentation, #proactivedocumentaiton, #preemptivedocumentationfordenialsavoidance https://lnkd.in/eibQQ5cZ

Physicians today face increasing challenges in managing their practices efficiently amidst various pressures like price constraints, healthcare reforms, and declining reimbursements. To maintain focus on patient care, partnering with a medical practice management company can be beneficial. NANI, a prominent figure in nephrology since 1976, offers extensive expertise in the field. Learn more about partnering with a recognized leader in nephrology here: https://lnkd.in/e6gch9mN

Split/Shared E/M Visits can be a tricky business, but we are here to help! 🥼 Discover the intricacies of E/M visits shared between physicians and nonphysician practitioners (NPPs) in our latest blog post. Learn how these collaborative encounters are billed and gain clarity on the substantive portion determination crucial for accurate reimbursement. https://hubs.la/Q02pDPhM0 Stay informed with the latest regulations and guidelines impacting your practice with ECLAT #HealthcareBilling #EandMVisits #MedicalCoding #HealthcareRegulations #RCM #RevenueCycleManagement

Running an internal or family medicine clinical trial? Enrollment can be a challenge, but at Elligo Health Research, we’ve designed a model that makes a real difference. Our approach helps ensure successful patient recruitment and retention by leveraging deep relationships with providers and integrating technology to streamline the process. #ClinicalTrials #PatientRecruitment #FamilyMedicine #ElligoHealthResearch #ClinicalResearch #TrialSuccess #HealthInnovation https://lnkd.in/dTVhx9pY

With Massachusetts' new stroke regulations anticipated in early 2025, now is the time for hospital stakeholders to prepare. Let's take a closer look at the four levels of hospital certification by reviewing the criteria for Primary Stroke Certification (PSC). PSC recognizes hospitals with established protocols for immediate stroke evaluation, potentially through telemedicine, and the ability to administer thrombolytic treatment when appropriate. PSCs have Stroke Units or designated beds for the acute care of stroke patients. For PSCs providing neurosurgical services, the OR is available 24/7. PSCs play a critical role in ensuring swift patient transfer to higher-level stroke centers in cases needing specialized interventions. Learn more and find already certified centers using the links below. https://lnkd.in/eiftcRpr https://lnkd.in/eqCpV9Dx #PrimaryStrokeCenter #HealthcareExcellence #StrokeCare #FASTStroke #StrokeTreatment #NeurologyCare

Highlighting this helpful summary of considerations for structuring physician recruitment arrangements in a compliant manner written by my friends Zachary Doolin, CVA, MAcc and Carol Carden

𝐇𝐨𝐰 𝐆𝐞𝐧𝐞𝐫𝐚𝐥 𝐏𝐫𝐚𝐜𝐭𝐢𝐜𝐞 𝐒𝐩𝐞𝐜𝐢𝐚𝐥𝐢𝐬𝐭𝐬 𝐋𝐭𝐝 𝐜𝐚𝐧 𝐡𝐞𝐥𝐩 𝐲𝐨𝐮𝐫 𝐆𝐏 𝐏𝐫𝐚𝐜𝐭𝐢𝐜𝐞 𝐬𝐚𝐯𝐞 𝐫𝐞𝐬𝐨𝐮𝐫𝐜𝐞𝐬.. GP Specialists Ltd was recently engaged to support a GP Practice in processing abnormal lab results using ARRS funding. By adapting their bespoke, protocol-driven approach to meet the high standards set by the practice’s partners, they achieved impressive results: Time saved: Over three months of service, GP Specialists Ltd saved 3 hours of GP clinical time per day, allowing the practice team to focus more on patient care and other critical tasks. Reduced burnout: The reduction in administrative workload positively impacted staff well-being, leading to reduced stress and increased job satisfaction. Nurses and other team members reported a healthier, more productive work environment. Increased access: The practice experienced a 27% reduction in appointments required after blood results, contributing to increased patient satisfaction, with many benefiting from same-day turnaround on their results. This service is designed to optimize efficiency while improving the work environment for practice staff. Reach out to discover how GP Specialists Ltd can support your practice with their tailored solutions!