If you came across my recent report on the significant concern of “maternity deserts” in the U.S., as you will recall, the widely accepted definition of the phenomenon is any county lacking maternity care units.
The Centers for Medicare & Medicaid Services (CMS) just released news that they will be working on a 10-year payment and care delivery model called the Transforming Maternal Health Model (TMaH). This model strives to support participating state Medicaid agencies in developing and implementing a whole-person approach to pregnancy, childbirth, and postpartum care for women with Medicaid and Children’s Health Insurance Program (CHIP) coverage.
There are not a lot of details yet on how this program is going to be fleshed out, other than generic reference to key terms such as data, research, and evidence-based practice. However, I anticipate that more information will be coming in the first quarter of this year.
What we know so far is the following:
CMS is planning to release a notice of funding in the spring of 2024, with application submission requirements later in the year. Only 15 states will be awarded acceptance, with kickoff in January 2025.
Although I am thankful for the financial opportunity, and I don’t want to appear ungrateful, I am concerned about how this will end up trickling down to create scalable impact. Completing some quick math, $17 million divided per year would be $1.7 million annually for an entire state.
Let’s assume the Medicaid plan takes 20 percent prior to this going to the provider level, leaving $1.36 million to split – and this is just a conservative estimate. I am also concerned about what the other 35 states are going to do without the additional funding, as well as what health systems should consider for this year since funding would not begin until 2025. To learn more, click here: Transforming Maternal Health (TMaH) Model | CMS
Artificial intelligence (AI) has revolutionized the way industries operate, and healthcare is no exception. Since the introduction of generative AI tools like large language models
Happy New Year! You may be planning on hitting the gym a little more frequently, or maybe you are hoping to lose a few pounds.
Please log in to your account to comment on this article.
Prepare your organization for the 2025 OPPS updates with expert insights from Tiffani Bouchard, CCS, CRCR, a Revenue Integrity Professional with over 30 years of experience. This webcast will address critical challenges in charge capture and coding, providing clarity on APC policies, C-APC packaging, exclusions, and payer-specific requirements. Attendees will learn actionable strategies to ensure compliance, optimize reimbursement, and mitigate risks of claim denials. Gain the knowledge needed to implement updates effectively, educate your team, and maintain seamless revenue cycle operations in the face of evolving OPPS complexities.
Join Beth Wolf, MD, CPC, CCDS, for an in-depth webcast on the FY2025 spinal fusion MS-DRG updates. Discover key changes in DRG classification, understand impacts on documentation and CMI, and learn strategies to ensure compliance.
Join Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, as she presents effective strategies to strengthen collaboration between CDI, coding, and quality departments in acute care hospitals. Angela will also share guidance on implementing cross-departmental meetings, using shared KPIs, and engaging leadership to foster a culture of collaboration. Attendees will gain actionable tools to optimize documentation accuracy, elevate quality metrics, and drive a unified approach to healthcare goals, ultimately enhancing both patient outcomes and organizational performance.
Optimize your outpatient clinical documentation and gain comprehensive knowledge from foundational practices to advanced technologies, ensuring improved patient care and organizational and financial success. This webcast bundle provides a holistic approach to outpatient CDI, empowering you to implement best practices from the ground up and leverage advanced strategies for superior results. You will gain actionable insights to improve documentation quality, patient care, compliance, and financial outcomes.
The 2025 Medicare Physician Fee Schedule brings significant changes to payment rates, coverage, and coding for physician services, impacting practices nationwide. Join Stanley Nachimson, MS., as he provides a comprehensive guide to understanding these updates, offering actionable insights on new Medicare-covered services, revised coding rules, and payment policies effective January 1. Learn how to adapt your practices to maintain compliance, maximize reimbursement, and plan for revenue in 2025. Whether you’re a physician, coder, or financial staff member, this session equips you with the tools to navigate Medicare’s evolving requirements confidently and efficiently.
Dr. Ronald Hirsch provides critical details on the new Medicare Appeal Process for Status Changes for patients whose status changes during their hospital stay. He also delves into other scenarios of hospital patients receiving custodial care or medically unnecessary services where patient notifications may be needed along with the processes necessary to ensure compliance with state and federal guidance.
Healthcare organizations face complex regulatory requirements under the No Surprises Act and Price Transparency rules. These policies mandate extensive fee disclosures across settings, and confusion is widespread—many hospitals remain unaware they must post every contracted rate. Non-compliance could lead to costly penalties, financial loss, and legal risks. Join David M. Glaser Esq. as he shows you how to navigate these regulations effectively.
Protect your facility from unwanted audits! Join Becky Jacobsen, BSN, RN, MBS, CCS-P, CPC, CPEDC, CBCS, CEMC, and take a deep dive into both the CMS and AMA guidelines for reporting post operative pain blocks. You’ll learn how to determine if the nerve block is separately codable with real life examples for better understanding. Becky will also cover how to evaluate whether documentation supports medical necessity, offer recommendations for stronger documentation practices, and provide guidance on educating providers about documentation requirements. She’ll include a discussion of appropriate modifier and diagnosis coding assignment so that you can be confident that your billing of post operative pain blocks is fully supported and compliant.
Copyright © 2025 ICD10monitor. Powered by MedLearn Media.
Prepare for the 2025 CMS IPPS Final Rule with ICD10monitor’s IPPSPalooza! Click HERE to learn more
Get 15% OFF on all educational webcasts at ICD10monitor with code JULYFOURTH24 until July 4, 2024—start learning today!
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
