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As the healthcare industry faces increased scrutiny, especially in medical coding accuracy and regulatory compliance, recent surveys reveal that many professionals are concerned with issues like upcoding, audit discrepancies, and the integration of artificial intelligence in coding practices. According to a Black Book survey , 90% of HIM professionals believe that upcoding is a significant ethical concern, while 85% say that discrepancies identified during coding audits often lead to denied clai
By using computational fluid dynamics software and other modeling techniques for complex congenital heart disease patients, Boston Children's Hospital's pediatric cardiology team said it now better understands flow balance and characteristics in preoperative planning and is improving surgical decision-making and patient outcomes. Turning to CFD for decision support As a parent, when finding out your child's heart does not work perfectly, you turn to the most gifted surgeons you can f
Chase County Community Hospital has faced a number of challenges similar to those confronted by many other rural health systems. Chief among them was a growing shortage of physicians, a problem projected to worsen in the coming years. THE CHALLENGE Chase is a 15-bed critical access hospital in Imperial, Nebraska. Like many rural healthcare organizations, the facility relies heavily on advanced practice providers – nurse practitioners and physician associates.
Environment Fighting Wildfires with Chemicals: The Controversy and Danger of Flame Retardant Materials For the past week, I have watched my beloved city of Los Angeles become engulfed in flames. My heart aches knowing that the places I once lovedthe Will Rogers beach house, the Palisades lookout, and a drive up the Pacific Coast Highwaywill never be the same.
Based on comprehensive survey data from diverse healthcare providers, the 2025 HIPAA Benchmark Report delivers actionable intelligence for modern compliance programs. This report examines how organizations are restructuring HIPAA Privacy Programs to address emerging regulatory requirements. Through analysis of staffing models, program operations, and breach management protocols, it provides a clear picture of current best practices.
In a complex, multimodal imaging environment, with radiology and other images and reports scattered across any number of PACS systems and electronic health records, clinical and technology leaders at Cleveland-based MetroHealth had one "guiding North Star," says Dr. David Kaelber, the health system's chief health informatics officer and VP of patient engagement technologies.
The following is a guest article by Ty Greenhalgh, Industry Principal of Healthcare at Claroty Cybersecurity in the healthcare sector faces persistent challenges despite increasing awareness and the implementation of targeted guidance, such as the HHS Healthcare and Public Health (HPH) Cybersecurity Performance Goals (CPGs) , which are nearing their one-year mark.
The secure exchange of sensitive patient data is a top priority for healthcare organizations. 2024 exposed healthcares privacy and security vulnerabilities with three of the nations largest data breaches to date: Change Healthcare, Ascension and Kaiser Permanente. And last year, patient safety and quality ranked 5.9 out of 11 in the list of health system executives concerns.
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Health Care Compliance Brief brings together the best content for health law & compliance professionals from the widest variety of industry thought leaders.
The secure exchange of sensitive patient data is a top priority for healthcare organizations. 2024 exposed healthcares privacy and security vulnerabilities with three of the nations largest data breaches to date: Change Healthcare, Ascension and Kaiser Permanente. And last year, patient safety and quality ranked 5.9 out of 11 in the list of health system executives concerns.
Robert F. Kennedy Jr. incorrectly said that Medicaid was fully funded by the federal government and that Medicare is a fee-for-service program during a hearing in front of the Senate Finance Committee on Wednesday.
Clinical documentation requirements can be copious and time-consuming. While concurrent documentation is taught and encouraged, it is a skill that takes time to master – and even when done well can cause a clinician to feel or appear distracted during a patient visit. THE CHALLENGE Trying to actively listen and provide quality care while having to focus on recording accurate and complete details of a conversation in a note can be challenging even for an experienced therapist.
Frank Fawzi, IntelePeer CEO In todays digital-first world, AI-powered automation is redefining how we approach both customer and healthcare patient experiences. While AI has already made its mark across industries, its application in healthcare introduces a unique opportunity to enhance patient experience (PX) at a time when the industry is grappling with unprecedented challenges, including staffing shortages and increased demand.
As the healthcare industry faces growing patient demand , artificial intelligence (AI) and automation are giving hospitals and health systems the opportunity to rethink how they deliver care. However, many organizations struggle with where and how to deploy these technologies. “AI is not a hammer looking for a nail,” emphasized Dave Henriksen, Head of Value Based Care at Notable.
Every health care provider that accepts federal payments must screen for excluded providers. Use this sample Exclusion Screening Checklist and Compliance Policy to evaluate and improve your organization’s compliance with the law. Payments from Medicare, Medicaid, and TriCare trigger screening requirements that may extend to employees, contractors, volunteers, board members, and network providers.
The Company Comes Out of Stealth with $5M and in Collaboration with 25+ Partners to Support Transparent and Accessible Data Analytics Tuva Health , the world’s first open-source healthcare data transformation platform, launched out of stealth today with $5M in seed funding. The company offers payers, providers, and pharmaceutical companies the ability to transform claims and EHR datasets into analytics-ready data tables via an open-source data model with built-in normalization, data qualit
Mandatory Alternative Payment Model Performance Pathway (APP) reporting begins this year, bringing significant changes for Accountable Care Organizations (ACOs). As we move into this new reporting era, the question isnt whether to act but how to act effectively. Choosing the right reporting method is critical to ensure compliance and maximize your ACOs return.
The year-long inquiry into hospitals managed by Apollo Global Management and Leonard Green & Partners comes amid growing calls for increased oversight of private equity in healthcare.
The past year saw varying levels of digital transformations going around the health systems in Asia-Pacific. It has increasingly become evident that digitalisation – from nationwide networks down to individual hospitals – has become the rule in a post-pandemic world. AI and virtual care models continued to be the craze in healthcare, owing to their clear support for improving clinician productivity and patient outcomes.
Payroll compliance is a cornerstone of business success, yet for small and midsize businesses, it’s becoming increasingly challenging to navigate the ever-evolving landscape of federal, state, and local regulations. Mistakes can lead to costly penalties and operational disruptions, making it essential to adopt advanced solutions that ensure accuracy and efficiency.
A 2023 systematic review published in BMC Nursing revealed a strong connection between clinical nurse competence and patient safety culture, underscoring the transformative impact of comprehensive training on nursing skills. Restorative nursing stands as a cornerstone of healthcare, dedicated to enhancing patients’ quality of life by helping them regain or maintain their highest levels of function and independence.
As healthcare continues to advance with accountable care organizations and value-based care models, the industry is starting to see some real traction after a decade of groundwork in the form of CMS claims for the Medicare Shared Savings Program. There are some critical elements driving success here. The role of medication adherence and patient engagement are pivotal factors for continuing to achieve ACO and VBC goals.
Healthcare is the last bastion for many technologies of yesteryear. Fax machines, pagers, compact discs (CDs), clipboards, printed educational materials, and only offering a phone number to book an appointment remain prevalent in healthcare despite having been all but phased out in other industries. Many of the speakers at conferences last year pleaded with audiences to put more effort into adopting modern approaches to better solve healthcares challenges like patient experience, interoperabili
NORRISTOWN, Pa. January 15, 2025 MRO Corp. (MRO), the leading clinical data exchange company in healthcare, is pleased to announce its CEO, Jason Brown, was named one of The Top 50 Healthcare Technology CEOs of 2024 , following several years of client expansion and growth. This years Top CEO list features individuals whose leadership has been a driving force behind some of the most significant advancements in healthcare.
Healthcare communication has evolved from handwritten notes and paper charts to digital tools like EHRs, telemedicine, and AI-powered platforms. This blog explores how these advancements improve patient outcomes, streamline care delivery, and enhance provider collaboration. Learn about the role of mobile health (mHealth) apps, secure messaging, and social media in bridging communication gaps.
Experts say the future of AI regulation is uncertain in 2025 with a new presidential administration. Also this year, organizations will continue to bolster their cyber defenses to withstand increasing attacks.
For veterans that have had an in-person visit with Veterans Affairs' providers, the Drug Enforcement Administration is extending those provider-patient relationships to all VA practitioners engaging in telemedicine with the patient, DEA said in a statement Friday. Jointly released with the Department of Justice, the Substance Abuse and Mental Health Services Administration and the Department of Health and Human Services, the new final rule says VA telehealth prescribers do not have to take p
Nursing homes should serve as sanctuaries of care, compassion, and safety for the elderly and vulnerable. Yet, abuse within these settings remains a pervasive and often hidden crisis, impacting countless individuals worldwide. Alarmingly, approximately 1 in 6 individuals aged 60 or older have experienced some form of abuse in community settings, including nursing homes, according to the World Health Organization (WHO).
Hospitals and health systems have been discussing digital-first patient engagement for a while now, but fewer organizations than you might think have made huge strides forward on that front. Likewise, data-driven decision-making is a phrase that's been tossed around quite a bit in healthcare, but in many cases it's a dream that's yet to become reality.
Let's discuss the trusty pager—an old favorite that’s losing its shine in hospitals and clinics. While once a staple in hospitals and clinics, pagers now present significant limitations that hinder rather than facilitate communication among healthcare professionals. Healthcare professionals are constantly on the move, and they need communication tools that can keep up with their fast-paced lives.
The following is a guest article by Joseph M. Saunders, Founder and CEO at RunSafe Security Modern healthcare settings are full of devices that use software to manage and improve patient care, from MRI machines to CT scanners to infusion pumps. Healthcare providers rely on medical device manufacturers to deliver secure and effective software upfront, but securing software once these devices are already in the field is another challenge altogether.
Healthcare NOW Radio Podcast Network MRO Exchange: Automated record retrieval w/ CHRISTUS Health's RCS Director, Prudence Budemer S2E2: Host Anthony Murray, MRO’s Chief Interoperability Officer, discusses automated record retrieval with CHRISTUS Health’s Revenue Cycle Services Director, Prudence Budemer. Together they dive into how CHRISTUS and MRO are utilizing FHIR to facilitate the retrieval of medical records required for specific use cases while maintaining the integrity of
On Wednesday, a faith-based group of investors requested UnitedHealth prepare a report looking into how its practices could be leading to “delay or abandonment of medical treatment and serious adverse events for patients.
The U.S. Drug Enforcement Agency has released its notice of proposed rulemaking for a framework to permit medically necessary controlled substances without an in-person visit without violating the Ryan Haight Online Pharmacy Consumer Protection Act. WHY IT MATTERS The NPRM comes two months after the DEA and U.S. Health and Human Services announced they extended the pandemic-era virtual prescribing of controlled substances a third time.
Large enterprises face unique challenges in optimizing their Business Intelligence (BI) output due to the sheer scale and complexity of their operations. Unlike smaller organizations, where basic BI features and simple dashboards might suffice, enterprises must manage vast amounts of data from diverse sources. What are the top modern BI use cases for enterprise businesses to help you get a leg up on the competition?
Andrea Greco, SVP of Healthcare Safety, CENTEGIX Jennifer Schmitz, MSN, EMT-P, CEN, CPEN, FNP-C, NE-BC, VP of Client Engagement, Engage, powered by the ENA De-escalation is a critical skill in healthcare, particularly in environments where emotions run high, and patients and their families may be under significant stress. Effective de-escalation requires not only the ability to manage conflict but also an understanding of human emotions, empathy, and a well-practiced response to high-tension sit
Dozens of health systems representing millions of patients across the United States are collaborating with the Truveta Genome Project, Regeneron Genetics Center and genomic sequencing company Illumina to sequence the exomes of their first ten million volunteers. As part of what may be the largest and most diverse sequencing project of genotypic and phenotypic information ever assembled, the health systems said in Truveta's announcement Monday that their collaboration would aid in the develop
Proposed Changes Require Strong Cybersecurity The newly proposed changes to the 2013 HIPAA Security Rule published yesterday in the U.S. Federal Register include strict cybersecurity requirements that leave little wiggle room for healthcare providers, health plans, and their business associates to avoid implementing strong cybersecurity practices, including validation that their business partners also meet their HIPAA requirements.
2025 has arrived and with it brings new challenges and potential opportunities to the healthcare landscape. Payers face increasing regulatory demands, heightened expectations for interoperability, a renewed focus on payment integrity, and rising pressure to address health equity. These changes can feel daunting, but with the right tools and strategies, payers can thrive, innovate, and build stronger partnerships.
In healthcare, where patient data protection is paramount, effective vendor risk management isn't just good business—it's essential for maintaining compliance and trust. This comprehensive guide helps healthcare compliance professionals navigate the complexities of third-party vendor relationships in an increasingly interconnected healthcare environment.
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