As the COVID-19 pandemic reaches the two-year mark, there is discussion about moving into the endemic stage, living with COVID and any future variants as we have learned to live with the flu. On this episode, leading experts cover whether or not COVID is here to stay, national attitudes about living with it and the possibility of eradicating it in the future.

Guest speakers:

Martin Lucenti, MD, PhD

Moderator:

Show Notes:

[00:54] Pandemic vs. endemic

[01:36] Two considerations in moving from pandemic to endemic

[04:58] Possibility of eradicating COVID

[06:04] What data shows about getting to endemic state

[07:38] Most COVID public health policies came from Spanish Flu era

[08:41] Synergies between public health agencies and health care providers

Links | Resources:

To contact Modern Practice: [email protected]

Dr. McDowell’s contact email: [email protected]

Dr. Lucenti’s contact email: [email protected]

“What will it be like when COVID-19 becomes endemic?” (Interview with Yonatan Grad for Chan School of Public Health at Harvard) Click here

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We continue our discussion on quality and safety. We talk about always improving on messaging and telling the patient story which connects back to what the data shows. We also talk about value based purchasing and connecting the quality story to the financial impact. We touch on strategic plans and quality metrics while taking into account national scorecard priorities. We also talk about creative initiatives for physicians, having shorter meetings, and effective safety huddles.

Guest speaker:

Moderator:

Show Notes:

[00:41] Gaining executive buy-in for your quality agenda

[02:36] Quality reputation and connecting the story with the financial impact

[03:46] Measures to include in a leadership dashboard and a service line dashboard

[04:36] Communicating with physicians and showing results to move the dial

[05:11] Creatively engaging physicians in quality initiatives and meeting them where they’re at

[07:50] Having effective patient safety huddles driven and led by the executive team 

[09:41] Being nimble and creative while still dealing with daily clinical challenges 

[10:46] The quality agenda should be top of mind 

[11:26] It's important to support each other

Links | Resources:

To contact Modern Practice: [email protected]

Charlene Sanders contact email: [email protected]

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Now more than ever, it is critical that health care organizations advance quality while operating efficiently.  This episode explores best practices for quality department structure, governance and priorities, while looking ahead to the opportunities new technologies may bring.

Guest speaker:

Moderator:

Show Notes:

[00:51] Quality department reporting structure

[03:30] Quality governance

[04:42] Getting buy-in from and information to clinicians

[05:24] Optimal FTE mix for quality

[06:37] Determining priorities

[07:10] Impact of COVID on quality initiatives

[09:40] Impact of new technology

[10:49] Quality scorecards

[11:57] Data overload

Links | Resources:

To contact Modern Practice: [email protected]

Charlene Sanders contact email: [email protected]

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It has been a year since the American Medical Association released new guidelines for Evaluation and Management (E&M) codes, revising and replacing guidelines issued back in 1995 and 1997. This episode reviews the impact of these changes, which are intended to make the codes more relevant in today’s practice and easier for documentation.

Guest speaker:

Moderator:

Show Notes:

[01:10] Changes to outpatient clinic codes only so far

[02:00] Process meant to be easier

[02:49] Codes that were dropped

[03:34] History and physical do not go into level determination but still needed

[04:34] Medical decision-making

[07:16] Time includes face-to-face and non-face-to-face: examples of what’s included

[08:33] What isn’t included in time component

[09:51] Intent of the new rules

[10:14] Prolonged services

Links | Resources:

To contact Modern Practice: [email protected]

Sheila Bowlds’ contact email: [email protected]

2021 Office Visit Evaluation and Management (E/M) Changes (ACOG) Click here

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A robust and effective clinical documentation program needs a strong partnership between clinical documentation specialists and coders. Yet, rifts can occur between those two groups, and this episode examines how those differences happen, why it is important to cultivate and encourage this vital partnership.

Guest speaker:

Moderator:

Show Notes:

[00:39] Story of a rift between clinical documentation specialists and coders

[03:55] Conflict is common

[04:17] Value of cooperation

[05:01] Miscoding a helicopter ride to the hospital

[06:48] Taking the time

Links | Resources:

To contact Modern Practice: [email protected]

Rachel Mack’s contact email: [email protected]

What is CDI and how does it impact you? (AAPM) Click here

Addressing Provider Clinical Documentation Challenges: New Technology Solutions Improve Accuracy (Vizient) Click here

Vizient’s CDI App Click here

What Does a Clinical Documentation Specialist Do Day-to-Day? Click here

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This episode continues an examination of CDI software, considering how best to use the technology and take into account the need for critical thinking beyond it. Cutting-edge automation does not replace the skills of CDI specialists and coders.

Guest speaker:

Moderator:

Show Notes:

[00:49] Essentials to keep in mind when using CDI software technology during concurrent review

[02:10] Origins of CDI technology

[03:30] Virtual versus in-person

[04:13] Interrelationship of CDI specialists and coders

[06:10] The perfect marriage

[07:22] Keys to success

[09:04] Partnering with physicians

Links | Resources:

To contact Modern Practice: [email protected]

Rachel Mack’s contact email: [email protected]

What is CDI and how does it impact you? (AAPM) Click here

Addressing Provider Clinical Documentation Challenges: New Technology Solutions Improve Accuracy (Vizient) Click here

Vizient’s CDI App Click here

What Does a Clinical Documentation Specialist Do Day-to-Day? Click here

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Clinical documentation improvement (CDI) is crucial for full and accurate reimbursement and reduced compliance risks. Many software programs provide automation to assist coding and prioritization. However, clinical documentation specialists (CDSs) and coding professionals need to use these enhanced software tools along with critical thinking skills to take advantage of query opportunities. On this episode, we’ll discuss how to effectively use CDI technology.

Guest speaker:

Rachel Mack, MSN, CCDS, CDIP, CCS, CRC

Consulting Director, Clinical Documentation

Vizient

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Principal, Clinical Operations and Quality

Vizient

Show Notes:

[01:40] Each physician document holds importance for the patient

[02:10] Origins of CDI technology

[03:21] CDI technology today: advantages and drawbacks

[06:28] Example: when there’s a need to avoid technology dependence

[07:43] Need for critical thinking apart from the technology

[09:48] Choose the software well

Links | Resources:

To contact Modern Practice: [email protected]

Rachel Mack’s contact email: [email protected]

What is CDI and how does it impact you? (AAPM) Click here

Addressing Provider Clinical Documentation Challenges: New Technology Solutions Improve Accuracy (Vizient) Click here

Vizient’s CDI App Click here

What Does a Clinical Documentation Specialist Do Day-to-Day? Click here

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This episode is the final in the series on the final MACRA Rule for 2022. An excerpt from the recent Medical Leadership Series webcast, the discussion on this episode focuses on MIPS Accountable Care Organizations (ACOs), Business Associate Agreements (BAAs) , new performance category percentages, the Outpatient Prospective Payment System (OPPS) and other issues.

Guest speakers:

Valinda Rutledge, MBA, MSN

Senior Advisor, Sg2

Vizient

Madeleine McDowell, MD

Principal and Medical Director, Sg2

Vizient

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Principal

Clinical Operations and Quality

Vizient

Show Notes:

[00:30] MIPS Accountable Care Organization changes and the CMS web interface

[04:41] Need to look at Business Associate Agreements (BAAs)

[05:09] Standard performance of ACOs – changes and the new threshold

[07:11] Chance that some ACOs may not achieve savings at all

[07:41] Issues around the Outpatient Prospective Payment System (OPPS)

[10:20] Key insights overall

Links | Resources:

To contact Modern Practice: [email protected]

Maddie McDowell’s contact email: [email protected]

Valinda Rutledge’s contact email? [email protected]

Program handout from December 8, 2021 Vizient Medical Leadership Series webcast: Click here

Link to December 8 webcast: Click here

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This episode, an excerpt from the recent Medical Leadership Series webcast, continues the discussion of the final MACRA Rule for 2022, focusing on challenges providers now face as MACRA progresses into next year and the serious consideration providers should give to joining an Alternative Payment Model (APM). Also part of the discussion are MIPS Value Pathways (MVPs) and Advanced Alternative Payment Models (aAPMs).

Guest speakers:

Valinda Rutledge, MBA, MSN

Senior Advisor, Sg2

Vizient

Madeleine McDowell, MD

Principal and Medical Director, Sg2

Vizient

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Principal

Clinical Operations and Quality

Vizient

Show Notes:

[00:27] Uncontrollable circumstance exemption for COVID-19

[02:22] Changes to the final score

[03:36] “The juice ain’t worth the squeeze anymore”

[03:56] The only way to do well

[04:33] The heavy lift: the reporting burden

[05:46] MIPS Value Pathways (MVPs)

[07:41] Advanced Alternative Payment Models (aAPMs)

Links | Resources:

To contact Modern Practice: [email protected]

Maddie McDowell’s contact email: [email protected]

Valinda Rutledge’s contact email? [email protected]

Program handout from December 8, 2021 Vizient Medical Leadership Series webcast: Click here

Link to December 8 webcast: Click here

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For physician and clinician leaders, this episode provides the latest information on the final MACRA Rule for 2022, including regulatory activities impacting reimbursement. We will discuss the Merit-based Incentive Payment System (MIPS), Alternative Payment Models (APMs), telehealth reimbursement, split visit payment rules and other information crucial to physicians and clinicians.

Guest speakers:

Valinda Rutledge, MBA, MSN

Senior Advisor, Sg2

Vizient

Madeleine McDowell, MD

Principal and Medical Director, Sg2

Vizient

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Principal

Clinical Operations and Quality

Vizient

Show Notes:

[01:58] Concerning changes to payments

[04:31] Split visits

[07:56] Telehealth coverage

[09:10] MACRA—details and ramifications

Links | Resources:

To contact Modern Practice: [email protected]

Maddie McDowell’s contact email: [email protected]

Valinda Rutledge’s contact email? [email protected]

Program handout from December 8, 2021 Vizient Medical Leadership Series webcast: Click here

Link to December 8 webcast: Click here

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