Medicare Compliance & Reimbursement - 2009 Issue 14
PHYSICIAN NOTES: CMS Establishes Care Transitions Project to Cut Down on Hospital Readmissions
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Article Overview
This article covers a CMS initiative testing new community-based care transition approaches in selected regions to address Medicare hospital readmissions, along with a brief note about a Medicare carrier fix for rejected physician service claims tied to hospice care. It is relevant to billing staff, compliance teams, hospital discharge planners, and coders who follow Medicare policy developments and claims processing issues. The article provides a high-level overview of the program and the general problem CMS is trying to address without going into detailed coding guidance.
Why This Topic Matters
Hospital readmissions and claims rejection issues can affect reimbursement, workflow, and coordination across settings of care. Readers tracking Medicare policy and billing operations may want to understand the scope of the CMS project and the related hospice claims note.
What You Will Learn
- The purpose and focus of CMS’s Care Transitions Project
- Why hospital readmissions are a Medicare policy concern
- How community-based transition models are being used in selected regions
- The general context of a Medicare carrier fix related to hospice-associated physician service claims
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Hospital administrators
- Care transition coordinators
- Revenue cycle teams
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