On Sept. 30, the Centers for Medicare & Medicaid Services (CMS) released the FFY 2025 IPPS Interim Final Rule with comment period (IFC) , marking a significant shift in how hospitals manage their wage index challenges. Designed to address disparities between low and high wage index hospitals, the rule modifies the federal fiscal year (FFY) 2025 hospital inpatient prospective payment system (PPS) low wage index policy.   This blog post will explore the IFC and its implications for the healthcare industry. In addition, we'll provide insights on the IPPS analysis based on the final rule — so you can best navigate these changes with the most up-to-date adoptions.  Key changes in the FFY 2025 IPPS Interim Final Rule  The FFY 2025 IPPS IFC brings several critical changes to the existing structure of hospital reimbursements under Medicare. Initially implemented in FFY 2020, the low wage index policy aimed to adjust hospital reimbursements to bridge the gap between high ...

Health equity remains one of the most pressing challenges in the healthcare industry today. The Centers for Medicare and Medicaid Services (CMS) is taking a significant step forward with the Making Care Primary (MCP) model to address these disparities.  CMS' MCP model aims to improve care quality and ensure that everyone, regardless of their background, has access to essential health services. Using CMS' goals and perspective, we will explore how the MCP model promotes health equity, its crucial components and its implications for healthcare professionals.  Understanding the Making Care Primary Model  CMS is leveraging the MCP model to transform the delivery of primary care services, using insights from previous models like Primary Care First (PCF). It focuses on supporting healthcare providers in delivering advanced care that meets patients' diverse needs, aiming to create a more equitable healthcare system.  The MCP model is about improving patient outcomes and emp...

Second quarter 2024 Statewide Planning and Research Cooperative System (SPARCS) data submissions are due. To help you keep track of SPARCS deadlines, we put together a downloadable infographic detailing the most important dates for the second quarter of 2024 .    Don’t forget about your Q1 2024 SPARCS data submissions  The third final warning and statement of deficiency issue date for Q1 2024 is here. Don’t forget these Q1 2024 compliance deadlines this quarter:  Sept. 15, 2024: An audit was performed for the final third warning of Q1 2024 data. Facilities that have not resolved their Q1 2024 data errors prior to this date after receiving three warnings will be issued a SOD.  Oct. 15, 2024: Facilities were audited for Q1 2024 data compliance and issued an SOD.  Key Q2 2024 SPARCS data compliance audit dates  Sept. 30  Submission deadline for Q2 2024 data   You avoided penalties if you submitted your Q2 2024 SPARCS data by this date....

Healthcare systems in New York face several challenges in boosting physician loyalty. Physicians' desire for competitive compensation and affiliation with dominant systems influences their decisions. Additionally, physicians' preference for larger, urban settings over smaller, rural areas complicates efforts to distribute medical talent evenly across regions. Addressing these challenges requires tailored strategies to effectively attract and retain physicians.  In this blog post, we’ll look at key physician loyalty trends. We’ll also examine how Sg2’s MarketEdge platform can help identify ways to improve physician loyalty in your organization.   New York healthcare market trends: Research on rural vs. urban physicians In 2012, the Center for Health Workforce Studies, within the University at Albany’s School of Public Health, compared physicians working in New York City to those in rural areas. The study, “ Rural and Urban Physicians in New York ,” found that:  There are ...

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 touc...

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...

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...