Health IT tip of the day: Prepare for changes in clinical compliance from CMS

Medicare is increasing the number and complexity of clinical compliance requirements, particularly in the area of readmissions. Medicaid and commercial carriers may follow suit.

Barbara Waxenfelter, RN, Senior Manager, EY Health Advisory Services, Pittsburgh, PA: Provider payments and penalties are increasingly being tied to clinical quality. Robust clinical IT services and data warehouses are critical to accurately identifying and tracking data required for compliance. 2016 will bring an increase in penalties and in the number of conditions for readmissions, as well as changes to algorithms used. Providers should invest now in effective data warehousing and health care analytics to avoid decreased revenues and increased penalties.

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