Topics: Patient Care and Interaction
With Hurricane Harvey’s recent devastation of the Texas gulf coast fresh in our memories, and Hurricane Irma about to make landfall in Florida, now is a good time to consider your practice’s preparation for a hurricane or any other disaster. It's not too late to prepare! While not every eventuality can be anticipated, there are a few basic steps you can take that will give your practice the best chance of returning to patient service as quickly and completely as possible after a natural disaster.
Compliance requirements with ACA Section 1557
Last year, the U.S. Department of Health and Human Services (HHS), and the Office for Civil Rights (OCR) issued the final rule for Section 1557, the nondiscrimination provision of the Affordable Care Act (ACA).
Over the past ten years, MagMutual has spent an estimated $15 million dollars defending cases involving shoulder dystocia and associated complications. While the majority of these cases involved quality medical care, they were frequently difficult to defend because important aspects of the delivery were not recorded or were only partially documented in the medical record.
The clock is ticking on the initial reporting period for MACRA; the actions you take now will determine your Medicare reimbursement rates in 2019. If you plan to participate in MIPS, failure to take any action will result in a 4% negative adjustment to your Medicare reimbursement in 2019. An overview of MACRA and its potential impact on your practice can be found here.
Accurate information about a patient’s past history is vital for decision making in every physician-patient interaction. In addition, proper documentation is essential for care that may be provided in the future by yourself or other physicians. Coordination of care is as much of a patient safety challenge as making an accurate diagnosis or ordering the appropriate treatment. The path of care from the initial complaint to completion of treatment is far from seamless. Sometimes it can be full of obstacles – such as the potential to misunderstand or not see important information, including details that could pose serious risks for the patient. Many medical liability cases involve poorly coordinated care that results in harm to a patient.
A 28-year-old G1 P0 female presents in active labor after an uncomplicated pregnancy. She progressed adequately in labor, getting an epidural at 6cm dilatation. After delivery of the fetal head, the head partially withdraws back into the birth canal (turtle head) and this was immediately noted. A modified McRoberts’ maneuver was done with suprapubic pressure without success.
If you participate in Medicare Part B and if you don’t take action before October 2nd you will receive a 4% negative payment adjustment in 2019.
What is MACRA?
The Medicare Access and CHIP Reauthorization Act (MACRA) repealed the Sustainable Growth Rate methodology used to update physician fee schedule reimbursement and replaced it with a new reimbursement model, the Quality Payment Program (QPP). Through MACRA physicians will fall into one of two tracks:
Physician recruiting is a fact of life for any practice. Whether it’s replacing a retiring solo practitioner, adding an employee physician to a three-person partnership, or adding additional manpower to a large, multi-specialty clinic, physician recruitment is inevitable and the financial stakes are high.
A recent Emergency Medical Journal article examined the relationship between empathy and litigation. The authors enrolled two groups of patients into a randomized, double-blind controlled trial. The subjects watched simulated discharge discussions between physicians and standardized patients; half of the videos differed only by the inclusion of two brief empathy statements. These verbalizations included: 1) a reflection on the patients' concerns about their symptoms, and 2) a reflection on their health awareness.