Cindy Bauer, BSN, RN

100% satisfaction in birth metrics! What is the secret? Cleveland Clinic achieved 100% satisfaction across five birth metrics, a notable feat that Becker's Hospital Review highlighted. Cleveland Clinic adopted TeamBirth in October 2022. TeamBirth is a care delivery model jointly created in 2021 by Harvard Pilgrim Health Care, Ariadne Labs and UMass Memorial Health. It emphasizes routine check-ins with all patient care team members and family at key points to streamline communication about birth preferences and patient status, using a whiteboard as a key tool. Since adopting it, the health system saw the rate of C-sections for Black mothers go down from 41% to 22%. Rates also improved for white mothers, dropping from 27% to 23%, bringing the outcomes for its patient populations to a more equitable level. ▶ Satisfaction went up across five categories in 2022 to a perfect 100% for: ➡ Friendliness/courtesy of the unit — up 10% from 2022. ➡ Staff concern, information about progress and baby’s condition — up 12% from 2022. ➡ Nurse promptness in responding to patient call — up 12% from 2022. ➡ Nurse's attitude toward patient requests — up 13% from 2022. ➡ Doctor and staff working together during birth — up 15% from 2022. Patient satisfaction grew by 23% — from 72% in 2022 to 95% in 2024 — for how well they felt Cleveland Clinic managed their pain during labour. Transparent communication is important to promoting safety and reliability in high-risk organizations. ♻ How is the communication in your organization? #healthcare #communication #reliability

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☝ Don't Miss the Application Deadlines for the ACO Primary Care Flex Model! CMS is accepting applications for the ACOs Primary Care Flex Model until August 1, 2024. Interested organizations must apply as new or renewing ACOs to the Medicare Shared Savings Program (MSSP) by June 17, 2024. The ACO PC Flex Model will launch on January 1, 2025, and run for five years. Low-revenue ACOs participating in the Shared Savings Program can apply to the ACO PC Flex Model. This innovative model aims to increase the number of low-revenue ACOs and enhance primary care payment through a Prospective Primary Care Payment (PPCP) option, shifting payment from fee-for-service to a predictable, monthly payment. 💲 Enhance primary care payment and innovative care delivery  📉 Narrow Disparities in health care outcomes  🔻Reduce program expenditures while preserving the quality of care  💪 Strengthen participation incentives for new and low-revenue ACOs 💰 Base Rate and Payment Enhancements  💴 One-time Advanced Shared Savings Payment Health Equity Strategy to drive accountable care and advance health equity #ACOPrimaryCareFlexModel #HealthcareInnovation #PrimaryCare #AccountableCare #Medicare #HealthEquity #SustainableHealthcare #ValueBasedCare #VBC #RiskAdjustment #PPCP #SharedSavings #CMS https://lnkd.in/gmiKZsHM

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Enhancing Quality Improvement in Hospitals with ORControl™ Quality Improvement (QI) in healthcare isn’t just about outcomes—it’s about creating smoother, safer, and more efficient processes. ORControl™ empowers hospitals with minute-by-minute coordination, optimized OR utilization, and instant day-of-surgery insights, helping clinical teams stay aligned and proactive. By addressing challenges as they happen, ORControl supports a more streamlined, patient-centered approach to perioperative operations and day-of-surgery workflows. Learn more about how ORControl is transforming QI initiatives and advancing healthcare standards in this article by Becker's Health. View full article below ⬇

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📝 The Importance of Advance Directives: Planning for Your Healthcare Future Have you thought about what kind of medical care you want if you can't speak for yourself? Advance directives are crucial for ensuring your healthcare wishes are known and respected. Here’s why they matter: 1️⃣ Empowerment: Take control of your healthcare decisions by outlining your preferences in advance. 2️⃣ Family Peace of Mind: Spare your loved ones the stress of making tough decisions during difficult times. Clear guidelines help avoid family disagreements. 3️⃣ Legal Protection: Advance directives ensure that your wishes are honored by healthcare providers, reducing the chances of unwanted treatments. 4️⃣ Flexibility: You can update your directives anytime as your preferences or circumstances change. 5️⃣Avoiding Prolonged Suffering: Advance directives can help prevent unnecessary or unwanted medical interventions that might extend suffering or diminish quality of life. 6️⃣ Clarity for Healthcare Providers: Having clear instructions in place helps healthcare providers make timely and informed decisions aligned with your values and preferences. 🌟 Start the conversation with your family and healthcare provider today! Do you have one in place? If so, like this post!  ✨Check out my newest book for more information, “The Roadmap to Hospital Care,” available now on Amazon to purchase! Link below:  https://lnkd.in/ggZGPfAi #AdvanceDirectives #HealthcarePlanning #PatientEmpowerment #HealthcareFuture #LivingWill ##AdvanceDirectives #HealthcarePlanning #LivingWill #HealthcareProxy #DurablePowerOfAttorney #PatientEmpowerment #HealthcareDecisions #PeaceOfMind #MedicalPlanning #InformedConsent #HealthLiteracy #EndOfLifeCare #PatientRights #WishesMatter #LifePlanning #HealthCareAwareness #FuturePlanning #KnowYourOptions #PlanAhead #FamilyHealth #WellnessJourney #HealthcareFuture #EmpowerYourself #LegalDocuments #HealthCareChoices #SelfAdvocacy #PatientAdvocacy #TakeControl #YourVoice #HealthcareSupport

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It's wild to think in 2024 we're FIRST seeing the DOJ accuse telemedicine conglomerates of criminal drug distribution. How long have we known about these practices in brick and mortar care...? Answer: decades! Take it from someone who prescribed stimulants and other psychotropics to kids over the years - painstakingly measuring and documenting the need and impact - these appalling abuses by Done and Cerebral mean we need more calls for thoughtful pause when it comes to working with startups. Particularly about funding's role - my favorite topic! 🤑 How did we end up with venture capital and PE financing in healthcare that risk the safety of kids in the name of exorbitant returns? Not that all VC or PE dollars are bad, of course, but they're certainly key drivers who shouldn't be in that seat. Did we underestimate these funders as 'barbarians at the gate', much like the pharma reps of the 90's and early 2000's heyday? Have we not learned from Purdue Pharma's aggressive and deadly Oxoycontin marketing? Purdue pleaded guilty to criminal charges and paid $600 million in fines in 2007. Or TAP Pharmaceutical Products's Lupron kickback scheme for the prostate cancer drug? TAP also pleaded guilty to criminal charges and paid $875 million in fines in 2001. Or Pfizer marketing Neurontin, an anti-seizure drug, for off-label uses, such as treating pain and bipolar disorder, even though the drug was not approved for these purposes, and paying physicians kickbacks. In 2004, Pfizer pleaded guilty to criminal charges and paid $430 million in fines. Cerebral and Done's playbooks were practically the same thing, just with a modern mid-pandemic, low-regulatory scrutiny, digital-platform twist. Will appropriate regulation ever outpace American venture greed? Is it even possible to ensure patient safety AHEAD of tragedies driven by the intersection of innovation and venture funding? If you're keeping score, healthcare regulatory reactivity: 1 million. Healthcare ounces of smartly preventive policy: 3. Blech. 😖 When will we finally own that prevention in-house? #healthcare #overdoseprevention #suicideprevention

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The Association of Healthcare Value Analysis Professionals (AHVAP) celebrates Elizabeth Eisenberg, MSN, RN, CVAHP from Scripps Health for commitment to excellence in the specialty of healthcare value analysis! Liz has signified this commitment by signing the official Association of Healthcare Value Analysis Professionals (AHVAP) healthcare value analysis pledge. To learn more about the Association of Healthcare Value Analysis Professionals (AHVAP) Commitment pledge: https://lnkd.in/gqEWPBue. #AHVAP #valuebasedcare #excellenceincare #valueanalysis

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Healthcare Consultants You Should Know: Erkeda DeRouen, MD ✨ Digital Health Risk Management Consultant ⚕️TEDxer | Helps healthcare organizations devoted to digital health excellence minimize risk and expenses linked to non-compliance and under-optimized workflows. Lawanna Gaddy RN, MSN - Quality Care Management Consultant | Helps healthcare organizations committed to NCQA Excellence, implement quality care management programs to eliminate compliance risks and associated financial burdens. Leilani Schweitzer – TedX Keynote Speaker, Patient Harm Expert | Helps patient-centric healthcare organizations effectively communicate with patients after adverse events, protecting their reputations and avoiding costly malpractice lawsuits. Monique Small, RHIT Healthcare Data Analysis Consultant with RCM Specialization | Helps healthcare organizations proactively prevent revenue leakage through advanced analytics by identifying and addressing potential inefficiencies, and promoting operational excellence for sustained growth. Natalie Dillon, MPH - Healthcare Analytics Consultant | Helps healthcare professionals harness their existing skills and expertise to forge rewarding paths in healthcare analytics through tailored coaching and mentorship. I've had the privilege of mentoring these exceptional healthcare leaders over the past two quarters, and to say I'm impressed would be an understatement. They've achieved what many aspire to do, but few dare to accomplish—taking bold, decisive action to shift from healthcare leaders to impactful healthcare consultants. I'm proud. -Elle #HealthcareConsultants #BusinessMastery #Healthcare

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Want to know exactly what Medicare will pay your hospital for a specific admission and the impact a CDI query will have on the case? Google your hospital's "CMS provider number" -Systems may use the same number for multiple hospitals so you might need to dig a little Go to this website: CMS.webpricer.gov and click on "Inpatient PPS" Enter the following: Your hospital's provider number that you Googled Admit & discharge date: make them up to a recent time period Total charges: put 10K if unsure, it won't matter except for outlier cases Covered days: put enough days that cover the length-of-stay DRG: Google "MS-DRG Relative Weight table 5" to get a list of all DRGs Click "Estimate" and you'll see your hospital's payment on the right. You can also scroll down and see your hospital's "cost-to-charge ratio", which is a factor in outlier payments. You can click "Edit Claim" and enter higher charges if you want to see when outlier payments start to kick in or try different DRGs If you want to see the impact of a query that takes a case from a "W/O CC/MCC" (without complication/comorbidity, major complication/comorbidity) to an "MCC" (major complication/comorbidity), enter the MS-DRGs that go with each of those, so DRG 379 for w/o cc/mcc and DRG 377 w/MCC in the GI bleed examples in the slides. The attached slides show a snippet of the CMS relative weight table with GI bleed highlighted to show you the different relative weights of the three severity levels for that DRG. Other DRGs may have just one or two severity levels Next slide is a snapshot of the CMS CC/MCC list with "viral pneumonia" highlighted as a major complication/comorbidity (MCC) Last two slides show you how the payment is calculated for a hospital (UCLA in this case) for the GI Bleed MS-DRG and the impact of a query for "viral pneumonia" that increased the severity from a "WO CC/MCC" to "W MCC" This isn't just for adult patients. There are 12 states that pay Medicaid by MS-DRG and plenty of commercial payers in every state that pay by MS-DRG. Contact Pediatric Resource Group (PRG) to help you develop or optimize CDI for your pediatric/neonatal patients. Don't have peds? We have an adult consulting division as well called Physician Resource Group (PRG) #CDI #revenuecycle #hospitalfinance #MSDRG #CFO #clinicaldocumentation

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🚀 What if you could double your ACO's performance? Healthcare organizations managing 50K Medicare lives are leaving millions on the table. But there's a solution. Top ACOs are activating their value-based care flywheel through: ✅ Automating data analytics while preserving expert clinical judgment ✅ Turning real-time performance insights into actionable workflows ✅ Building a systematic approach to network and contract optimization Ready to activate your value-based care flywheel? 💡 Get the playbook that's helping leading ACOs maximize their potential: https://lnkd.in/g-q63AG9 #HealthcareInnovation Sean Hogan | Amy Stevens | Brian Silverstein, MD

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If over 50% of the births in Mississippi are financed by #Medicaid and over 75% of Medicaid recipients are in #managedcare, it makes sense to review contract requirements for managed care organizations. The organizations play a fundamental role in assuring timely, equitable, quality care and improving maternal health outcomes. In this article, Milbank Quarterly offers a close review of managed care contracts and shows that the absence of a national set of #maternalhealth standards has caused challenges in setting expectations for managed care performance. Table 1 in the study offers a summary of contractual findings, including in #Mississippi. Twenty-five contracts require perinatal risk assessments by the MCO or a provider, but most of these contracts do not require risk assessments throughout the full continuum of care. Only two states require risk assessment in the postpartum period (California and Louisiana). Yet nearly half of pregnancy-related deaths occur one week to one year after delivery, when most individuals would have left the hospital. All MCOs are required to include obstetrician gynecologists (OB-GYNs) in network, and seven states explicitly require high-risk obstetrician specialists (maternal–fetal medicine). Mississippi is not one of those states. Full article: https://lnkd.in/gF-45tJ2

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Health literacy is vital for advancing Medicaid equity. Center for Health Care Strategies latest resource equips healthcare professionals with practical strategies to improve how they communicate with Medicaid members, ensuring patients understand and access the care they deserve. Strengthening these communication efforts helps break down barriers, fosters trust, and leads to more equitable health outcomes. Explore these insights to enhance patient engagement and drive better results in your community.

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MEDICARE BUDGET NEUTRALITY ISN'T VERY NEUTRAL A new survey's findings show that physician reimbursement has per patient decreased by 2.3% between 2005 and 2021. KEY TAKEAWAYS Findings show that patients saw a 45.5% increase in services, compared to the 2.3% decrease in physician reimbursement per patient. Providers have been vocal in their opposition of the slashed Medicare rate, which was finalized in March. The impact of the trend of decreasing Medicare reimbursement for provider services hits home when one's parents have trouble scheduling neurology and gastroenterology consults due to providers no longer accepting Medicare, reimbursement is too low. Years of decreasing Medicare reimbursement eventually caused physicians to make a business decision to limit or no longer accept Medicare patients. Something needs to give, the good news is the solvency of the Medicare Trust fund is now extended to 2036. #Medicarepayment, #lowreimbursement, #decreasingreimbursement, #nopayraise https://lnkd.in/e8fBYkV7

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Epic Systems’ recent move to back the TEFCA medical records exchange is interesting. On the surface, it’s all about creating a seamless flow of patient data across hospitals, QHINs, and all relevant stakeholders. But let’s be real—data is the oil of the new economy, and interoperability is the pipeline that delivers this precious resource to all the right stakeholders. By aligning with TEFCA, Epic might just be positioning itself as the refinery. All in all, this is a welcoming move by Epic Systems—especially if it really is as straightforward as they make it sound. But given the lack of details, one has to wonder if there are any hidden catches. After all, when it comes to something as valuable as healthcare data, it’s wise to look out for the fine print. Let’s hope this is genuinely about improving patient care. https://lnkd.in/gDdDCcmj

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Cityblock found that value-based care can improve health and reduce unnecessary costs for persons with cooccurring psychiatric and SUD. https://lnkd.in/eHiSvyWt Michael Tang, MD, MBA

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