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Practice Management Basics: From Getting Started to Staffing Addressed in New Medical Home Builder Modules

Posted on May 17, 2012 by


Philadelphia, PA (PRWEB) May 17, 2012

Starting a medical practice requires specialized business and legal knowledgeareas generally not included in medical school curricula. Physicians are smart to be fully informed about legal issues, insurance, billing, marketing and finances. Then, once the practice is up and running, the medical practice will need to manage staffing and human resource issues.

Practice Basics and Human Resourcestwo new modules added to the American College of Physicians Medical Home Builder online tooladdress these critical issues. These additions to the popular online practice management tool from the American College of Physicians (ACP) are designed to help doctors successfully start (or expand) their practices and navigate the basics of human resource issues for clinical and administrative staff .

A robust, yet easy-to-use, self-paced online tool, Medical Home Builder 2.0 enables clinicians and their staffs to measure andwhere neededimprove patient care, office procedures and procedural workflows.

Managing a successful medical office in todays world requires sound business and management skills in addition to the necessary clinical training and education, said Dr. Michael S. Barr, ACPs senior vice president for the division of medical practice, professionalism and quality. Before physicians can have their questions answeredthey need know the right questions to ask. These new modules address the fundamental business and practice management concerns needed to start, or manage, a successful practice.

The Practice Basics module provides users with the framework for creating a sound practice. Fundamental issues covered include insurance, billing and collections, state and federal regulations, HIPAA, OSHA, Medicare Part D and workers compensation. Issues related to setting up an in-office laboratory are also covered. Finally, the module addresses the essential, but often overlooked, task of developing a marketing and promotion plan for the practice.

Having the right people doing the right job at the right time is critical for any successful organization or medical practice. Important federal and state regulations apply to the management of clinical and administrative staff as well as generally recognized best practices. Unfortunately, many practices are either unaware of the regulations or mistakenly believe that good office communication can replace a formal review process. The Human Resources module covers federal employment regulations (state-by-state laws are not included) as well as proven personnel management policies.

Many new offices do not spend enough effort on complying with applicable federal and state regulations or on establishing basic policies and procedures to guide office operations and personnel management, explained Michael Barr. The recruitment and retention of qualified staff are essential parts of building a high quality, patient-centered practice.

This module includes links to information about many of the federal regulations regarding employees as well as practical articles and sample job descriptions, policies and procedures templates and other information needed for personnel management. It includes information for the employment of both clinicians and staff, including compensation and benefits.

Many of the resources provided in the Practice Basics module were identified by the ACP Council of Young Physicians based on the needs of residents going into practice.

Medical Home Builder 2.0 users are part of an online community of practices that are committed to improving patient care and office operations. Not every practice using Medical Home Builder is planning to become a recognized medical homebut all find value in the variety of modules available and guidance provided. Each person in participating practices has access to all of the content in the Medical Home Builder including the self-assessment questions, peer-to-peer videos and a community discussion forum where questions can be posed to colleagues. For more information, visit http://www.medicalhomebuilder.org.

About the American College of Physicians

The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 132,000 internal medicine physicians (internists), related subspecialists, and medical students, residents and fellows. Internists specialize in the prevention, detection, and treatment of illness in adults. Follow ACP on Twitter and Facebook.







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Medicare Rights Center

Posted on May 12, 2012 by

This video describes the Medicare Rights Center’s work to ensure access to affordable health care for older adults and people with disabilities through counseling, advocacy, education, and policy initiatives.

Medicare Rights Center

This video describes the Medicare Rights Center’s work to ensure access to affordable health care for older adults and people with disabilities through counseling, advocacy, education, and policy initiatives.
Video Rating: 5 / 5

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Abingdon at Tradition Wins Prestigious National Award

Posted on May 7, 2012 by

Port St. Lucie, FL (PRWEB) May 03, 2012

Abingdon at Tradition, a Port St. Lucie, Fla.-based retirement community, announced today that the communitys wellness program has won the Assisted Living Federation of Americas (ALFA) 2012 Best of the Best Award in the category of Clinical Wellness.

The communitys purpose-based wellness programming took home top honors in one of the most competitive categories, Clinical Wellness. Purpose-based wellness programming is a collection of wellness programs developed specifically to counter the effects of chronic diseases or afflictions common among older adults.

The impetus for developing the wellness initiative was recent data which showed that a majority of Medicare, Medicaid and personal health care expenditures for adults 65 and older fall into two categories: the long-term management of chronic diseases and the immediate care required following a negative health event such as a fall or stroke.

Executive Director Kathy Kalck says the communitys purpose-based wellness programming addresses these needs by offering members alternative solutions to managing certain chronic diseases and by seeking to prevent avoidable health events such as falls. If a negative health event is considered unavoidable, she says the programming seeks to reduce a members length-of-stay in a long-term care setting.

One program, called Tour de Cure, incorporated the use of the recumbent bike, and strength and flexibility training to reduce or alleviate symptoms associated with Type 2 Diabetes.

These wellness programs are changing our members lives, said Kalck. This award is a formal acknowledgement of the good work we see our members and wellness directors doing every day.

Rick Grimes, president and CEO of ALFA, says the competition is designed to encourage the sharing of best practices.

We have the honor to spread the good news about remarkable resident-centered programs fulfilling every aspect of senior-living operations, from wellness services to staff development, said Grimes. All of this years entries speak to the high standard of innovation and professionalism among our members and demonstrate their resourcefulness and ingenuity.

Program submissions were judged for their uniqueness in the industry, innovative use of ideas from outside the industry, impact on residents, their families, staff and operations, embrace of industry core principles, the strength of quantitative and qualitative results, and strategic vision.

Winning programs and other innovative strategies are recognized in the May/June 2012 issue of the Senior Living Executive (http://www.alfapublications.org) and will be recognized at COMMUNITY 2012, the ALFA Conference and Expo. Learn more about the event for senior living executives at http://www.alfa.org/conference.

About Abingdon at Tradition

Abingdon at Tradition is an all-inclusive, luxury retirement community located in Port St. Lucie, Fla. The communitys care-free lifestyle helps members live longer, healthier and happier lives by offering an array of amenities including maintenance-free living, daily fine dining, weekly housekeeping, a nationally recognized wellness program and on-site health care services. Abingdon offers a variety of floor plans including single-family cottage homes and condominium-style villas. Assisted-living and Alzheimers care are also available for those who need to make a transition from independent living. More information about Abingdon at Tradition is located at http://www.Abingdon-Tradition.com.

ABOUT THE ASSISTED LIVING FEDERATION OF AMERICA

The Assisted Living Federation of America (ALFA) is the largest national association exclusively dedicated to professionally-managed, resident-centered senior living communities and the seniors and families they serve. Since 1990, ALFA has advocated for choice, accessibility, independence, dignity, and quality of life for all seniors. ALFAs programs promote business and operational excellence through education, research, publications, professional networking and online tools designed to foster innovation and entrepreneurism in the field of senior living. Visit ALFAs Web site at http://www.alfa.org.

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UPMC Health Plan Relies on Acero Health Technologies to Power HealthyU

Posted on May 2, 2012 by


Lorton, Va. (PRWEB) May 02, 2012

Medical and pharmacy claims for all of UPMC Health Plans HealthyU products are being effectively and efficiently processed by Acero Health Technologiess XpandCDH enterprise application.

UPMC Health Plan, the second-largest health insurer in Western Pennsylvania, is using XpandCDH to set up and administer a wide variety of consumer-driven spending accounts that are available with HealthyU. Since introducing HealthyU in late 2011, UPMC Health Plan has been relying on XpandCDH to provide its consumer-driven accounts with the same exceptional level of service and support available to members in all of its other products.

Implementing XpandCDH offered UPMC Health Plan both a comprehensive business solution as well as a scalable technical platform for our HealthyU products, said Ed McCallister, Chief Information Officer for the UPMC Insurance Services Division. UPMC and Acero partnered to create an integrated approach that allows us to quickly implement and manage new employer groups and members on HealthyU. This approach allows us to leverage our business knowledge, core systems and people while adding advanced, real-time CDH functionality.

HealthyU offers employers several plan options, each designed to reward members who exhibit healthy behaviors and become more involved in their health care decisions. HealthyU members may receive financial incentives by completing specific activities, such as a preventive care visit, a flu shot, or a health coaching program. Members can choose from more than 100 activities, developed from UPMC Health Plans award-winning wellness and care management programs.

XpandCDH is an integrated technology solution that facilitates enrollment, sophisticated contribution designs and claims processing for consumer-driven health plans. It ensures that members receive and use the correct amounts based on their particular plan design. The solution provides members and customer service with a consolidated, consistent and accurate view of benefits and claim information, including details related to the spending accounts.

The close integration between XpandCDH and UPMC Health Plans other core systems permits UPMC Health Plan to focus on its core administrative functions, while eliminating many of the synchronization issues that are sometimes associated with consumer-driven health solutions, says Alan Merchant, Chief Executive Officer of Acero. Consumers think of consumer-driven plans as a single product so it is important from a service perspective that health plans have the means to administer these types of plans in the same way.

By using XpandCDH we can enroll a new group or new individual members into HealthyU as easily as we can enroll a member into a PPO plan, said McCallister. We especially liked the real-time pharmacy integration which allows medical and pharmacy claims to be processed in coordination with the spending accounts. Using a real-time approach avoids many of the synchronization issues that might otherwise occur with PBM integration.

As a services-based application, XpandCDH offers health plans a robust, easy-to-manage technical solution that will scale as membership grows while also providing the sophisticated business functionality needed to implement many market-leading consumer-driven features such as stacked accounts, integrated pharmacy, embedded deductibles, and many others.

For more information about HealthyU, go to http://www.upmchealthyu.com.

About Acero Health Technologies

Acero Health Technologies, an innovative information technology company serving today’s healthcare visionaries, allows health plans to incrementally add software solutions to address new business challenges without requiring wholesale changes to existing investments. The Acero team has significant health plan and technical experience developing sophisticated enterprise software solutions for health plans and third-party benefits administrators. Aceros PlanXpandTM engine powers several technology solutions including XpandCDH, a powerful tool for administering consumer-driven health plans and XpandPBMTM an application that facilitates real-time integration of pharmacy and medical benefits. For more information, visit http://www.acerohealth.com.

About UPMC Health Plan

UPMC Health Plan, the second-largest health insurer in western Pennsylvania, is owned by UPMC, one of the nation’s top-ranked health systems. The integrated partner companies of the UPMC Insurance Services Division which includes UPMC Health Plan, UPMC WorkPartners, LifeSolutions (EAP), UPMC for You (Medical Assistance), and Community Care Behavioral Health offer a full range of group health insurance, Medicare, Special Needs, CHIP, Medical Assistance, behavioral health, employee assistance, and workers’ compensation products and services to nearly 1.8 million members. Our local provider network includes UPMC as well as community providers, totaling more than 125 hospitals and more than 11,500 physicians throughout Pennsylvania and parts of Ohio, West Virginia, and Maryland. For more information, visit http://www.upmchealthplan.com.

Media Contact:

Tom Brady

703.372.1480

Acero Health Technologies

press(at)acerohealth(dot)com







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Suing Nursing Homes

Posted on April 27, 2012 by

Suing Nursing Homes
In 1987, President Ronald Reagan signed into law the Omnibus Budget Reconciliation Act (OBRA), the first major version of the Federal standards for nursing home care since the 1965 creation of both Medicare and Medicaid (MediCal in California).
Read more on Huffington Post (blog)

In Congress, a Move to Look Into a Medical Debt Collector
A California representative is calling for an investigation into Accretive Health, one of the nation's largest collectors of medical debt, for potentially violating a federal law that requires hospitals to provide emergency care regardless of …
Read more on New York Times

Molina Healthcare fights to keep growing
It doesn't sell to employers or consumers; rather, it serves exclusively as a managed-care plan for government programs such as Medicaid and Medicare. It covers 1.7 million patients in California and nine other states. Those numbers could grow even …
Read more on Los Angeles Times

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Does anyone know of a health insurance company that pays the Medicare B premium?

Posted on April 22, 2012 by

Question by oneeye: Does anyone know of a health insurance company that pays the Medicare B premium?
I live in the formerly great state of California. A friend has her Medicare B insurance premiums paid by her insurance company. She was employed by a school system in California. Is there such a plan for non-school retirees? My current insurance says everyone must pay the Medicare B premium.

Best answer:

Answer by Dave
Never heard of such of thing. I suspect either you or she misunderstands her insurance coverage.

Know better? Leave your own answer in the comments!

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Latest Qualifications For Medicare News

Posted on April 17, 2012 by

Means-Tested Programs, Work Incentives, and Block Grants
In the case of open-ended entitlement programs such as Medicaid and SNAP, everyone who meets program qualifications has a legal right to receive the benefit. By contrast, in programs with capped spending such as housing programs and the major child …
Read more on Brookings Institution

So, What's Your Problem with Reverse Mortgages? Industry Leader Has Answers
Reverse mortgage borrowers will still qualify for Medicare and Social Security—programs that are available through age and entitlement qualifications, not on a needs basis. Needs-based programs such as Medicaid and Supplemental Security Income (SSI) …
Read more on SeniorJournal.com

Understanding Medicare Benefits
In terms of skilled nursing, this Medicare coverage is crucial in offsetting some of the expense. Depending on your loved one's level of care and need, their Medicare benefits may pay for some of their short-term costs. Qualifications for Medicare Part …
Read more on ValpoLife.com

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Guide to Using Joppel for Medicare Insurance

Posted on April 12, 2012 by

Joppel is a complete website resource for Medicare beneficiaries nationwide for both those aging-in as well as those already eligible. Joppel helps beneficiaries and their caregivers research and select health plans that best suit their personal needs. Joppel provides these services through an innovative website (www.joppel.com) that contains comprehensive, accurate and unbiased information and simplified tools to analyze and compare medicare health plan information. The Joppel website is supported by a fifty-state call center staffed by licensed benefit agents who are available for questions and can help to complete the application process.
Video Rating: 4 / 5

Medicare Fraud is costing us millions of dollars!

60 Minutes Exposes Medicare Fraud Part 1
Video Rating: 5 / 5

Posted in California Medicare | 8 Comment

Humana Medicare Advantage Plan

Posted on April 7, 2012 by

Learn more about Humana Medicare Advantage Plan for retirees and survivors.
Video Rating: 0 / 5

ABC NEWS/GOOD MORNING AMERICA: Senior With Fractured Back Battles UnitedHealthcare Oxford Health Insurance Company Medicare Advantage Plan GMA segment shows UnitedHealthcare/Oxford’s Medicare Advantage Plan would not authorize woman’s care due to alleged age discrimination. Audit shows Medicare Advantage providers with backlogs of unanswered patient complaints, plans that improperly denied claims, and concerns about marketing practices which do not follow government guidelines.
Video Rating: 5 / 5

Posted in California Medicare | 10 Comment

Dr. Wendy Lynch, co-director for the Center for Consumer Choice in Health Care at the Altarum Institute Interviewed on Health Care Consumerism Radio

Posted on April 2, 2012 by


Atlanta, GA (PRWEB) March 30, 2012

On Friday March 12th, Dr. Wendy Lynch, PhD, whose career has included roles as faculty at the University of Colorado Health Sciences Center, senior scientist at Health Decisions International, and principal at Mercer Human Resource Consulting joined host Ron Bachman on the new Healthcare Consumerism Radio show on Atlanta Business RadioX.

Dr. Lynch, who is the co-director for the Center for Consumer Choice in Health Care at the Altarum Institute and a senior scientist at the Health as Human Capital Foundation, sat down to discuss and provide a roadmap for companies navigating the new health and benefits landscape, which now includes five different generations of healthcare.

Show host Ron Bachman had this to say, What I love about your work is that you bring to the table the facts, figures, surveys and studies that really support the whole movement and why its going on and why its successful. Learning the real facts and figures lets consumers know what they should be doing and why they should be doing it.”

During the interview, Dr. Lynch noted that 60% of people do research before buying a car but only 28% do any research before finding a doctor. This is something she is working to change. Bachman agreed that this needed to change and pointed out another flaw in consumer thinking saying, Just because you consume more healthcare services doesnt make you healthier.

To learn more about Dr. Lynch and her research, listen to the interview online at the Healthcare Consumerism page for Atlanta Business RadioX.

About Ron Bachman:

Ron Bachman, co-host of HealthCare Consumerism Radio, is the Editorial Chairman of HealthCare Consumerism. Ron is an actuary with extensive experience in healthcare strategies for payers, providers, and employers. He is also the President and CEO of Healthcare Visions, Inc., a company whose goal is to advance consumer based solutions to lower the number of uninsureds, improve mental health coverage, develop the concept of consumer-centric Medicare and Medicaid, and advance employer introductions of healthcare consumerism. Ron is a retired partner of PricewaterhouseCoopers where he consulted to a broad range of clients including: employers, HMOs, hospitals, physicians, indemnity carriers, BlueCross BlueShield plans, as well as State and Federal Agency clients.

About Doug Field:

Doug Field, co-host of HealthCare Consumerism Radio, is the CEO and founder of The Institute for HealthCare Consumerism. The Institute (transitioned from CDHC Solutions) continues its dedication to providing visionary tools for industry leaders to learn, connect and share their insights in the ever-changing healthcare consumerism landscape. Doug specializes in business building and leadership, sales and marketing, M&A and content development.

About HealthCare Consumerism Radio:

http://healthcareconsumerismradio.businessradiox.com/

HealthCare Consumerism Radio is a weekly show co-hosted by CEO and Founder of The Institute for HealthCare Consumerism, Doug Field and Editorial Chairman, Ron Bachman. The Show airs every Friday at 11 am. The goal of The Institutes radio show is to help listeners learn about the latest trends and best practices in health care consumerism and connect them with health care industry thought leaders, brokers, advisors, third party administrators, HR and benefit managers and regional health plan providers. Listeners are encouraged to share by contacting the hosts of the show and suggesting archives to industry associates.

About Atlanta Business RadioX:

Atlanta Business RadioX provides a turnkey solution for business owners who want to leverage the power of internet radio to meet their best prospects, establish credibility for their organization and heighten the placement of their brand in search engines rankings. With a professional venue and a proven formula, Atlanta Business RadioX helps hosts podcast their shows and create a regular stream of dynamic content to share with their prospects and feed the search engines every week. Programs are recorded and streamed live to the internet from our corporate offices in suburban Atlanta. For more information or to see a live show, visit: http://www.BusinessRadioX.com.





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