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A Very Tepid Defense of the Physical Exam

Sensible Medicine

The differential diagnosis includes a rotator cuff strain (probably infraspinatus), osteoarthritis (maybe flared up with the gardening), the beginning of adhesive capsulitis (frozen shoulder), or even Lyme arthritis (again, given the gardening). He discharges the patient with instructions to follow up if necessary.

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Navigating Medicare Advantage: Strategies for Hospitals to Tackle Growing Challenges

EvidenceCare

CMS Policy Changes to Reduce Costs Financial pressures are rising as CMS implements the updated Version 28 Hierarchical Condition Category (HCC) model , which introduces changes aimed at limiting types of codes that are most used for up-coding or over-coding to help rein in spending. MA plans are looking for contradictions in provider notes.

Hospital 130
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Engaging Physicians in Quality Improvement: Strategies for Driving Practice Change

EvidenceCare

Real-time dashboards can also flag length of stay variance, prompting collaboration to streamline processes and free up capacity for higher-acuity admissions. Targeted clinical decision support , such as focusing on same-day discharge rates for low-risk patients, can increase evidence-aligned discharges and reduce readmissions.

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Will New Medicaid Policies Put Hospital Margins at Risk?

EvidenceCare

These improvements reflect stabilization following pandemic-related disruptions and cost pressures. Cost-Sharing: Medicaid recipients earning above the poverty line could face copays up to $35 per visit, capped at 5% of income. Effective care transitions and follow-up can improve outcomes and reduce unnecessary costs.

Hospital 130
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How Denver Health Reduced Length of Stay: A Step-by-Step Guide

EvidenceCare

They often provided data that was delayed by several weeks or aggregated at the service line level, which made it difficult to pinpoint actionable issues or analyze trends in real time by individual provider, DRG, or discharge unit. So Denver Healths internal analytics team built a custom data pipeline.

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Universal Depression Screening Leads to Unnecessary Harm

Sensible Medicine

The USPSTF claims "screening interventions" decrease the prevalence of depression at six-month follow-up by an odds ratio of 0.60. This number is surprising when we consider the following: A meta-analysis of six RCTs found the benefit of SSRIs, compared to placebo, to be small and statistically insignificant at six months.

Follow-Up 361
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Friday Reflection 41: Sometimes I Just Need to Complain

Sensible Medicine

What there was -- courtesy of colleagues from across the country – were cases illustrating needless excess, careless follow-up, poor commitment to clinical care, and the devaluation of primary care that undermines our entire system. She is discharged on dual-antiplatelet agents and an increased statin dose.

Follow-Up 273