Skip to main content

Posts

Trending failures: Level-up your SPARCS data submission

Elevate your coding standards with a new automation  In New York state’s intricate health system, it’s crucial to implement effective healthcare data management that meets Statewide Planning and Research Cooperative System (SPARCS) deadlines. The SPARCS Program requires consistent data submission reports. With the wrong system, SPARCS formatting and submissions can waste precious time and resources for health information management (HIM) coders, SPARCS data analysts and healthcare professionals.  With DataGen's UDS (UIS Data System™) new trending failures feature, you can automate more aspects of your SPARCS data to keep up with the evolving healthcare industry. Continue reading to learn how this functionality allows SPARCS data analysts and administrators to see repeat issues with coded records immediately and save your team precious time.   The cost of correcting records  Submitting records to SPARCS has significant financial implications. Each time a coder touches a record fo

CMS TEAM Model Q&A: Your 10 concerns addressed in partner webinar

DataGen partnered with the VBCExhibitHall and the Association of American Medical Colleges (AAMC) to host an informational webinar on CMS’ Transforming Episode Accountability Model (TEAM), Unpacking the mandatory CMS TEAM model: Overcome new rules & challenges.   During this one-hour session, attendees received valuable TEAM insights provided by Alyssa Dahl, vice president of advanced analytics at DataGen, and Erin Hahn, lead policy analyst of value-based care and quality at the Association of American Medical Colleges (AAMC). However, some attendees had good questions that we wanted to elaborate on — hence, the creation of this blog post! Speakers answer your webinar Q&As    With great participant questions during the Q&A portion, Dahl and Hahn took time to expand on their answers to provide more clarity.* So, if you’re a hospital with mandatory TEAM participation status, keep reading to unpack the new rules and challenges.    Q1: What happens to hospitals at risk during

How to prepare for a PCMH audit

Preparing for a Patient-Centered Medical Home (PCMH) audit can seem daunting, but with the right approach, it doesn't have to be. This guide aims to demystify the process and offer practical advice for healthcare administrators, PCMH participants and medical practices. Focusing on DataGen's Medical Practice Consulting services , we'll show you how to streamline annual reporting to ensure core criteria are consistently met in your workflow, so you can focus on coordinated care management and quality improvement within your care team or healthcare system.  Understanding the PCMH audit  PCMH annual reporting is essential for maintaining the integrity, effectiveness and recognition for the National Committee for Quality Assurance’s (NCQA) PCMH model . Each year, practices submit requirements to renew their recognition, showcasing a small portion of documentation across six concept areas. However, a PCMH audit requires a more comprehensive review. About 5% of annual reporters ar

Five key components of a strong patient safety culture

In today’s healthcare environment, ensuring patient safety is more than just a priority — it’s a fundamental component of quality care. Establishing a strong patient safety culture within hospitals and health organizations can dramatically reduce errors, increase patient satisfaction and improve overall healthcare outcomes. But what exactly is a patient safety culture, and how can institutions cultivate it effectively?  This blog post explores the five key components that make up a robust patient safety culture, along with insights from the Agency for Healthcare Research and Quality (AHRQ) and The Joint Commission.  What is patient safety culture?  AHRQ defines patient safety culture as how an organization's culture supports and promotes patient safety. This can extend to multiple levels, from individual units to departments to system levels. The AHRQ patient safety culture survey encompasses the shared values, beliefs and norms of healthcare practitioners and staff that influence

101 Guide: Quality Assessment and Performance Improvement (QAPI)

In today’s rapidly evolving healthcare landscape, quality assessment and performance improvement (QAPI) are crucial. These practices are essential for healthcare organizations that aim to enhance patient care while meeting regulatory and payer expectations.   That’s why we sat down with Mandi Diamond, senior practice transformation advisor at DataGen, to discuss the nuances. Read on for essential information on QAPI and how to measure your quality data.  What is quality assessment and performance improvement?  Defining quality assessment  The National Institutes of Health (NIH)  defines quality assessment (QA) as "the measurement of the technical and interpersonal aspects of health care and the outcomes of that care."   Diamond expands upon that definition, describing QA as the systematic evaluation of outcomes within an organization to measure the success of essential workflows.  Both definitions touch on the use of repeatable and systematic evaluations to measure the succes

New update: CMS releases mandatory TEAM hospital participants

Is your hospital one of the 741 acute care hospitals mandated?  On Sept. 5, the Centers for Medicare and Medicaid Services (CMS) took another significant step in transforming healthcare delivery by releasing the list of mandatory participants for the Transforming Episode Accountability Model (TEAM) .   If you’re a part of the 741 acute care hospitals selected for mandatory TEAM participation, here’s what you need to pay close attention to, as it marks a pivotal shift in how care is managed and Medicare costs are reconciled across the United States.  Two highlights from the CMS announcement  Mandatory participants announced  CMS’ list of acute care hospitals selected for mandatory participation in the TEAM model includes hospitals located within Core-based Statistical Areas (CBSAs) chosen by CMS. If your hospital is among those listed, it's imperative to understand the implications and prepare for upcoming changes.  Call to action for participating hospitals  CMS has requested that

Navigating healthcare's future: CMS CY 2025 OPPS released

Healthcare policy is constantly evolving, and with the release of the CMS calendar year 2025 OPPS proposed rule, healthcare providers and administrators have much to consider. This comprehensive guide aims to decode the proposed changes and their potential impact on the healthcare landscape. Whether you're a provider, hospital administrator, medical coder or other healthcare professional, understanding these updates is crucial for staying ahead.  Understanding the CMS CY 2025 OPPS proposed rule  On July 10, the Centers for Medicare & Medicaid Services (CMS) released the proposed CY 2025 payment rule for the Medicare outpatient prospective payment system (OPPS). This yearly update includes modifications that affect Medicare fee-for-service outpatient payment rates and introduces new policies aimed at improving healthcare delivery.  Key changes in the proposed rule  The proposed rule encompasses several notable changes, including the addition of services to the inpatient-only (IP