NEVADA MEDICAL GROUP MANAGEMENT ASSOCIATION

Latest News in Healthcare

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  • 12 Aug 2019 8:46 AM | Cathy Herring (Administrator)

    August 12, 2019

    Summer may have seemed longer than ever for those watching and waiting for the proposed 2020 Physician Fee Schedule — just ask the MGMA Government Affairs team.

    Thankfully, the Centers for Medicare & Medicaid Services (CMS) did release the proposed 2020 Physician Fee Schedule (PFS) at the end of July, which proposes changes to both Medicare physician payment and quality reporting program policies. The final rule is expected to be published in early November.

    If you missed the Aug. 7 member-exclusive webinar ("MGMA Regulatory and Payment Outlook") explaining the proposed changes, you can access it on demand. Members who have questions regarding any of these policies should contact MGMA Government Affairs staff at 202-293-3450 or govaff@mgma.org. 

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  • 05 Aug 2019 10:18 AM | Cathy Herring (Administrator)

    Whether this is your first MGMA Annual Conference or your 20th, MGMA19 | The Annual Conference, Oct. 13-16 in New Orleans has what you need propel you and your practice forward.  The Annual Conference is the place to connect with leaders in the industry, gain inspiration, gather innovative solutions and contribute to the advancement of medical practice management, to meet the challenges ahead. See you in New Orleans!

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  • 29 Jul 2019 8:14 AM | Cathy Herring (Administrator)

    July 29, 2019

    Using electronic tools to keep track of patients could be the key to enhanced efficiencies in healthcare, although the stigma of having someone looking over your shoulder still needs to be addressed with patients and staff alike.
     
    Kevin Hoover, MD, PhD,  Director of Musculoskeletal Imaging and Intervention at Virginia Commonwealth University, recently spoke to MGMA senior editor Daniel Williams on the MGMA Insider podcast to discuss advances in real-time location systems (RTLS) – tech tools designed to provide pinpoint monitoring of both patients and staff.

    Real-time location tools (RTLS)

    Hoover said the largely non-intrusive RTLS tools, contained in something as simple as a clip-on ID badge, allow instantaneous updates on patient whereabouts, and can yield data invaluable to integrating specialist services or even monitoring patient drug interactions.

    “It’s a neat tool,” he said. “What RTLS allows us to do is to know where someone is, and when they’re there. These are all really key pieces of information that allow us to optimize the time patients spend in one place. For example, if you’ve got a patient receiving infusion for a rheumatoid condition, which might take two hours, we want to know how long that patient is sitting there. Or you may just want to know how long that patient spent in a waiting room.”

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  • 22 Jul 2019 10:34 AM | Cathy Herring (Administrator)

    July 22, 2019

    Probably one of the trickiest parts of any physician practice administratively is understanding and effectively navigating insurance prior authorization requirements. There are many rules and regulations a provider must follow based on payer guidelines.

    Authorization guidelines are among some of the most murky and confusing guidelines of them all.  After 20 years of experience and many mistakes along the way I have outlined key elements of the referral, predetermination, authorization and precertification process. 

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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.


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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.

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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.

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