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Navigating Medicare Advantage: Strategies for Hospitals to Tackle Growing Challenges

EvidenceCare

Documentation Challenges and Payer Friction As MA plans focus on profit margins, hospitals are encountering increased payer friction, denials, and administrative burdens, particularly around the CMS Two-Midnight Rule. Document why you believe that. She provides education to physicians to document their internal monologue.

Hospital 130
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Connect Quality - New CPSA PPIP Project Now Available on Discharge Documentation

Connect Care Bytes Blog

We have organized the resources, training, reporting tools, and documentation required for you to meet CPSA PPIP requirements, so you can focus on looking after your patients. A template that can be used to document all CPSA requirements. Our goal is to make your work easier. An example Action Plan. Sign up today at connectquality.ca

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Preparing for CERT Audits and Practicing Compliant Documentation

EvidenceCare

This comprehensive guide provides hospital and revenue cycle leadership with vital insights on preparing for CERT audits and establishing processes for compliant documentation. This section delves into the specific criteria and expectations set by CERT audits, emphasizing the need for meticulous attention to detail and documentation accuracy.

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New Discharge Transfer Gateway to Replace Transfer and Discharge Navigators

Connect Care Bytes Blog

As of June 26, 2025 , a new “Discharge Transfer Gateway” can be found in all patient charts opened to an inpatient encounter. The Gateway replaces the prior “Transfer” and “Discharge” navigators. These include discharge to home, within-facility transfers, and inter-facility transfers (IFTs). ASAP, Critical Care).

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Is A Health Unit Coordinator Job Hard?

We Care Online

Managing admissions, transfers and discharges. Document and communicate with the healthcare team. Healthcare documentation. Key challenges include: Fast-Paced: Hospitals work on the basis of speedy and precise work which can get overwhelming Problem Solving: HUCs address scheduling conflicts or documentation problems quickly.

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New Insights on Medicare Advantage Plans and The Two-Midnight Rule

EvidenceCare

Robin Gantea, Executive Director of Utilization Management and Clinical Documentation Integrity from Baptist Health Jacksonville mentioned, “We haven’t seen changes in behavior related to the Two-Midnight Rule. We’re still facing the same types of denials, especially with short stays where payers push back post-discharge.”

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Insights from Digital Health Leaders at ViVE 2025

EvidenceCare

Dr. Wilcoxs journey into digital health started with a simple observation: patients in the post-anesthesia care unit were experiencing unnecessary delays in discharge, leading to longer hospital stays. The idea of integrating multiple solutions into one seamless experience is something I hadnt seen as much in the past, Wilcox shared.