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Upcoding: Why hospitals may bill for the most complex treatment

Michael Brady: Hello, and welcome back to Modern Healthcare s Beyond the Byline, where we offer behind-the-scenes look into our reporting. I m your host, Michael Brady. And I write about rules and regulations for Modern Healthcare. I m talking with our usual host, Alex Kacik, about his latest story on upcoding. So Alex, you reported on an inspector general report that found that hospitals are increasingly billing Medicare for the most complex treatment, even though data indicate that patients aren t getting any sicker. What did you make of the findings? Alex Kacik: Hey Mike, so the OIG s data resembles other research that I ve been reporting on for a couple of years now, and I thought those similarities were interesting. So the government watchdog agency found that the severity of stays that they re billing Medicare for is getting higher while the lower severity stays are getting lower. So that essentially means that you come in with a condition, maybe a respiratory condition, and y

Insurers are betting on virtual-first plans as COVID-19 shifts care pathways

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Beyond the Byline: Insurers are betting on virtual-first plans as COVID-19 shifts care pathways

How nursing home resident stories shape COVID vaccine coverage

How nursing home resident stories shape COVID vaccine coverage
modernhealthcare.com - get the latest breaking news, showbiz & celebrity photos, sport news & rumours, viral videos and top stories from modernhealthcare.com Daily Mail and Mail on Sunday newspapers.

How to help save rural health by saving rural hospital CEOs

Print There are more than 1,800 rural hospitals in the US about 47% of them are operating in the red. As operating margins decline, more than 450 of these hospitals are financially unstable. And within the last decade, more than 120 hospitals have shut their doors. Retaining CEOs is also a challenge, with drop-off rates exceeding 20% or even reaching 30% in many communities. Whenever the top leader departs, this can lead to other staff leaving and overall instability. In Episode #13 of Next Up, Modern Healthcare s Alex Kacik talks about what s needed to address the specific challenges rural hospitals are facing, and how new leaders can use innovation and creativity to keep these facilities up and running.

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