Medicare is a beneficial program for Americans who are over age 65 or have certain disabilities, but providers sometimes find compliance issues a challenge. An understanding of mandates and how to properly submit claims will ensure organizations are reimbursed for Medicare Part B-covered medications, equipment and supplies, such as nebulizer-inhalation medications, oral immunosuppressive drugs and diabetic testing supplies. Occasionally, providers may unknowingly submit noncompliant or even fraudulent claims for the products and services they offer.
News: Long-Term Care
We often equate regulatory mandates to government overreaching that impose roadblocks, which prevent pharmacists from providing solid healthcare to patients. However, changes and goals stemming from the Affordable Care Act (ACA) could actually give community pharmacies a new competitive advantage.
When the Meaningful Use process started, practices started being more diligent in collecting Business Associate Agreements from all their contractors who had access to their software.
Healthcare is ever changing and with those changes must come adaptation. There is a focus on quality of care versus quantity of care. Team-based care and pay-for-performance models are on the rise and pharmacists are a part of the equation.
In the previous edition of Insight, I said, “One competitive opportunity that never changes in pharmacy services is the percentage of your current customers who would recommend you to others.” I also mentioned, “Accomplishing high percentage scores requires a full-court press inside your operation for every employee to excel.”
Earlier this year, QS/1 partners, the Kentucky Department for Public Health (KDPH) and the Kentucky Pharmacists Association (KPhA), participated in a showcase to display the region’s overall capabilities to respond to a natural disaster or emergency and demonstrate services the state could provide, including fire, police, pharmacy and other disaster-response resources.
Flu season is here, meaning it is a great time to evaluate your status as an immunization provider. Since pharmacists are the most accessible healthcare professionals, we are valued members in our communities. Expanded scope and authority have provided pharmacists the ability to impact the availability and utilization of vaccines to a patient base that may not have otherwise been immunized.
On July 22, 2016, President Obama signed the Comprehensive Addiction and Recovery Act (CARA) into law. This is the first major federal addiction legislative package in decades and is designed to tackle the opioid epidemic through a six-part initiative: prevention, treatment, recovery, law enforcement, criminal justice reform and overdose reversal.
According to 2014 Centers for Disease Control and Prevention (CDC) data, 78 Americans die from an opioid overdose each day. The CDC has declared that the U.S. has a prescription drug abuse epidemic.
Value-Based Payment Reforms and Long-Term Care Pharmacy Opportunities: Hurricane on the Horizon or Smooth Sailing?
The pace of healthcare reform has never moved faster. Tectonic changes are shifting healthcare from a volume-based to a value-based business model. The Centers for Medicare & Medicaid Services (CMS), the nation’s largest payer of healthcare expenses, is leading the charge. Perspective is important when tallying America’s healthcare bill.