The Clinical View Blog

Keep up to date with the latest news and developments in Clinical Intelligence.

Observation or Inpatient Status?

A Closer Look at the Importance of Status Determinations Determining the appropriate status level for patients (Observation or Inpatient) at a hospital’s points of entry is critical. Correct status determination can increase patient satisfaction by avoiding...

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CMS Announcement: Short Stay Review Resume

After a brief pause for the Beneficiary and Family Centered Care (BFCC) Quality Improvement Organizations (QIOs), BFCC-QIOs will resume patient status reviews of short stays in acute care inpatient hospitals. Effective September 12, 2016, BFCC-QIOs will be performing...

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A Major Paradigm Shift Is Underway

At the recent HFMA Annual National Institute conference in Las Vegas, we learned more about the MAJOR PARADIGM shift underway, currently being driven by CMS. In June of 2016, CMS released the MACRA/MIPS draft rule, which is based on a proposed Quality Payment Program...

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The Paradigm Shift To MCOs: Are You Ready?

According to C. Kenneth Johnson, CEO of The ARMS Group, the transformation in healthcare is going to create a 25% growth in provider-owned managed care organizations (MCOs). But in order to seize this opportunity and succeed, providers will need to get the most out of...

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The Relationship Between Payments and CMI

Hospital executives focus on the Case Mix Index (CMI) as they review their clinical and financial data each month. CMI is a relative value assigned to each Diagnostic Related Group (DRG), and determines the allocation of resources for patient care.  An increasing CMI...

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