healthcare compliance and credentialing

More than 22 million people are enrolled in The Centers for Medicare & Medicaid Services’ (CMS) Medicare Advantage (MA) program. Most choose a plan based on CMS’ five-star quality rating; after all, who doesn’t want the best care available?

At the end of 2019, a novel virus was identified as the cause of a cluster of pneumonia cases in the Chinese city of Wuhan. As we now know, the COVID-19 outbreak spread to include over 80,000 cases in China and an increasing number of cases in other countries, prompting the World Health Organization (WHO) to declare Coronavirus or COVID-19 (initially called 2019-nCoV) a public health emergency of international concern. 

Hotels feature walls made of succulents and greet travelers with warm chocolate chip cookies on arrival. The elevator at the building downtown pipes in calming nature sounds. Movie theaters feel like plush living rooms. Now, the enhanced experiences consumers expect and receive elsewhere are coming to healthcare facilities. But more importantly, your organization’s quality scores and reimbursement levels increasingly depend on the ability to deliver an overall positive patient experience through improvements like hospitality and ambiance. 

Patients can turn to healthcare practitioners when they experience symptoms of burnout: emotional exhaustion, depersonalization, and a sense of reduced accomplishment at work. But many clinicians cite barriers that make them feel alone in coping with the same conditions. New approaches can help hospitals stem the tide of practitioner burnout and avoid its cascading effects: injury to patients or providers themselves, increased risk of malpractice, reduction in overall quality of care and patient outcomes, high provider turnover rates, and the like.

The U.S. spends over $3.5 trillion a year in healthcare, the equivalent of nearly $11,000 per person, supporting the continued need for qualified medical practitioners at every level. In order to get reimbursed for their services, healthcare organizations are being challenged to implement systems that improve the quality and consistency of patient care, as well as the patient experience.

One of the core challenges facing healthcare leadership is to ensure optimum reimbursement for the organization. Staying focused on the bottom line isn’t easy, especially when leaders are responsible for everything from culture to quality. Traditional fee-for-service models are being replaced by value-based healthcare. What does this mean for your organization?