New guide offers the possibility of improving a hospital’s bottom line.
Last week, The National Quality Forum and the American Hospital Association Center for Health Care Innovation released their how-to guide for hospitals and health systems seeking to implement, strengthen, and sustain tele-behavioral health.
Entitled Redesigning Care, the guide outlines an excellent framework for those contemplating building their own tele-behavioral health capabilities. But there are fundamental questions hospitals and health systems must ask themselves prior to embarking on such a significant investment in time, people and resources: is tele-behavioral health the answer to your prayers? Will it alleviate many of your clinical, financial, or operational issues? The answer is…maybe.
Success is largely dependent on how thoroughly you assess your current state and pinpoint the areas where tele-behavioral health can make the biggest impact on your patients and clinical operations: what measurable improvements can you reasonably expect and how will tele-behavioral health be incorporated into your clinical workflow? And success depends entirely on execution: even the most thoughtful, detailed plan is useless barring individuals knowing how their roles contribute to the overall efficacy of a functioning tele-behavioral health program. Otherwise stated, the devil is in the details and “one size fits all” most definitely does not work.
The Redesigning Care guide effectively articulates many of the challenges hospitals and health systems are currently facing as a result of the nationwide shortage of behavioral health professionals, especially psychiatrists. The primary challenge, from both a provider and patient standpoint, is, of course, that patients do not have access to swift, appropriate care for their behavioral health needs. However, this is just the proverbial tip of the iceberg as it relates to the broader set of challenges faced by hospitals and health systems. Boarding psychiatric patients in the emergency department (ED), bloated length of stay, both in the ED and hospital-wide, stress on ED staff who does not have access to the resources required to care for these patients appropriately are daunting challenges. Having framed the challenges, Redesigning Care goes on to suggest a possible solution – tele-behavioral health – and provide a framework that hospitals and health systems can use to build a successful tele-behavioral health program; a framework that touches on all the right considerations: leadership enfranchisement, operational and clinical workflow considerations, training and measurement among them.
Those of us in the physician advisor world, who view everything through the lens of improving clinical workflow and direct patient care, certainly believe that hospitals and health systems that afford these fundamentals their appropriate time and attention, will inherently address and alleviate the challenges outlined above, and, in doing so, will improve quality and outcomes, reduce length of stay, and eliminate psychiatric patients boarding in the ED.
Hospitals and health systems will also, albeit indirectly, improve the bottom line. While our focus is always the patient, another primary consideration is financial: understanding the details of the tele-medicine reimbursement model to ensure proper reimbursement for the quality care that is delivered, and more broadly recognizing how much revenue is lost when patients are boarded in the ED and inpatient units simply because there is no one available to treat them.
Redesigning Care provides a sound framework and articulates the key work streams required to create a tele-behavioral health practice. And while some hospitals and health systems have the resources (human and otherwise) to undertake this type of effort, others may not. For the latter, there is hope: hospitals and health systems can identify partners who specialize in telepsychiatry. For some, this may be a near-term solution they employ while simultaneously laying the groundwork for their own home-grown program. For others, the financial flexibility and ease of a “turn-key” solution may make sense indefinitely.
Regardless of which category a hospital or health system is in, having a partner that assumes much, if not all, of the burden associated with building a program, and understanding the regulatory and reimbursement landscape, represents a way to begin delivering superior patient care, alleviating bottlenecks and ensuring that the hospital or health system is optimizing its resources and revenue potential.
With a week off, I have much to report today to catch up. First, many of you may have heard or read that Medicare has
With just over a week left before the 2024 U.S. presidential election, reproductive rights have taken center stage as a critical issue for voters. The
Please log in to your account to comment on this article.
Optimize your outpatient clinical documentation and gain comprehensive knowledge from foundational practices to advanced technologies, ensuring improved patient care and organizational and financial success. This webcast bundle provides a holistic approach to outpatient CDI, empowering you to implement best practices from the ground up and leverage advanced strategies for superior results. You will gain actionable insights to improve documentation quality, patient care, compliance, and financial outcomes.
Enhancing outpatient clinical documentation is crucial for maintaining accuracy, compliance, and proper reimbursement in today’s complex healthcare environment. This webcast, presented by industry expert Angela Comfort, DBA, RHIA, CDIP, CCS, CCS-P, will provide you with actionable strategies to tackle complex challenges in outpatient documentation. You’ll learn how to craft detailed clinical narratives, utilize advanced EHR features, and implement accurate risk adjustment and HCC coding. The session also covers essential regulatory updates to keep your documentation practices compliant. Join us to gain the tools you need to improve documentation quality, support better patient care, and ensure financial integrity.
This webcast, presented by Angela Comfort, DBA, RHIA, CDIP, CCS, CCS-P, a recognized expert with over 30 years of experience, offers essential strategies to improve outpatient clinical documentation integrity. You will learn how to enhance the accuracy and completeness of patient records by adopting best practices in coding and incorporating Social Determinants of Health (SDOH). The session also highlights the role of technology, such as EHRs and CDI software, in improving documentation quality. By attending, you will gain practical insights into ensuring precise and compliant documentation, supporting patient care, and optimizing reimbursement. This webcast is crucial for those looking to address documentation gaps and elevate their coding practices.
ICD10monitor has teamed up with renowned CDI expert Dr. Erica Remer to bring you an exclusive webcast on how to recognize sepsis, how to get providers to give documentation that will support sepsis, and how to educate to avert sepsis denials. Register now and become a crucial piece of the solution to standardizing sepsis clinical practice, documentation, and coding at your facility.
Dr. Ronald Hirsch provides critical details on the new Medicare Appeal Process for Status Changes for patients whose status changes during their hospital stay. He also delves into other scenarios of hospital patients receiving custodial care or medically unnecessary services where patient notifications may be needed along with the processes necessary to ensure compliance with state and federal guidance.
Healthcare organizations face complex regulatory requirements under the No Surprises Act and Price Transparency rules. These policies mandate extensive fee disclosures across settings, and confusion is widespread—many hospitals remain unaware they must post every contracted rate. Non-compliance could lead to costly penalties, financial loss, and legal risks. Join David M. Glaser Esq. as he shows you how to navigate these regulations effectively.
Protect your facility from unwanted audits! Join Becky Jacobsen, BSN, RN, MBS, CCS-P, CPC, CPEDC, CBCS, CEMC, and take a deep dive into both the CMS and AMA guidelines for reporting post operative pain blocks. You’ll learn how to determine if the nerve block is separately codable with real life examples for better understanding. Becky will also cover how to evaluate whether documentation supports medical necessity, offer recommendations for stronger documentation practices, and provide guidance on educating providers about documentation requirements. She’ll include a discussion of appropriate modifier and diagnosis coding assignment so that you can be confident that your billing of post operative pain blocks is fully supported and compliant.
During this RACmonitor webcast Dr. Ronald Hirsch spotlights the areas of the OIG’s Work Plan and the findings of their most recent audits that impact utilization review, case management, and audit staff. He also provides his common-sense interpretation of the prevailing regulations related to those target issues. You’ll walk away better equipped with strategies to put in place immediately to reduce your risk of paybacks, increased scrutiny, and criminal penalties.
Copyright © 2024 RACmonitor. Powered by MedLearn Media.
Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →
👻Spooky Sale is Back!👻 Get 31% off all three Medlearn brands, using code SPOOKY24.
