Glenda Motta's blog

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by Glenda Motta RN, MPH

The Center for Medicare & Medicaid Services (CMS) reports that nearly one in five Medicare patients discharged from a hospital—approximately 2.6 million seniors—is readmitted within 30 days, at a cost of over $26 billion every year.

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by Glenda Motta RN, MPH

Anyone interested in keeping abreast of Medicare basics as well as payment policy should add the Medicare Payment Advisory Commission (MedPAC) to your list of resources. MedPAC, an independent congressional agency, advises the U.S. Congress on issues affecting the Medicare program. The Commission’s 17 members have diverse expertise in the financing and delivery of health care services.

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by Glenda Motta RN, MPH

Say what you will about Obamacare, but the President has made eliminating fraud, waste, and abuse in healthcare a top priority. The Attorney General and Health and Human Services (HHS) Secretary recently released a report on health care fraud prevention and enforcement efforts in Fiscal Year (FY) 2011.1 Nearly $4.1 billion was recovered, the highest ever reported. The Health Care Fraud Prevention & Enforcement Action Team (HEAT) works to prevent fraud, waste, and abuse in the Medicare and Medicaid programs. Their efforts and other approaches are being expanded using tools authorized by the Affordable Care Act.

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by Glenda Motta RN, MPH

Most individuals with chronic conditions would much prefer to remain at home in familiar surroundings than be relocated to a nursing care facility. Yet, the largest expenditures under state Medicaid programs involve providing institutional care for the chronic, long-term care population.

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by Glenda Motta RN, MPH

In 1978, I was hired to develop a comprehensive discharge planning program at an inner city hospital in Washington, D.C. Way before DRGs and any reimbursement limits were placed on hospitals, this facility knew it had a problem. 40 patients had a length of stay that exceeded 60 days! Can you imagine that scenario today?

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by Glenda Motta RN, MPH

Recently, I attended the WOCN Mid-Atlantic Regional conference. There, a nurse attorney discussed strategies to limit liability and improve patient care. The Maryland Patient Safety Law requires that hospitals report all Level I events to the state Office of Health Care Quality (OHCQ). The penalties for failing to meet these requirements can include revocation of the hospital’s license or a fine of $500 per day.

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by Glenda Motta RN, MPH

Centers for Medicare and Medicaid Services (CMS) just released regulations for acute and long-term care hospitals that include a new set of quality measures that will determine payment starting in the fiscal year 2015. The initial set of 10 quality measures was put in place in 2004 as mandated by the Medicare Prescription Drug, Improvement and Modernization Act (MMA).

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