Joseph MacDonald DO, MBA, FACOI

❗️Stepping Out Of Your Comfort Zone 👣 On our Round-Up with Sarah Ragan, COC, CPC, CPMA, CRC, CFPC, AAPC Approved Instructor, she mentioned how when you decide to step out of your comfort zone, that’s when your career really begins to take off! 🛫 It may seem scary especially when you’re used to something,🤔 but it will open a floodgate of new and better opportunities for you so give it a try! 🌊 We also talk about how you should be giving back after you receive help from someone else. 👋🫵 Let's say you need help with your job, once you receive that help, you can then help someone else with the same issue! 🤝 Giving back and stepping out of your comfort zone are great ways to open up new opportunities! 🎢🦋 👀 To watch the full Round-Up video with Sarah, click the link below! 👇 Be Renown, Bertram 🔔 Like | Comment | Share 🔔 #medicalcoding #healthinformation #comfortzone

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❗️Stepping Out Of Your Comfort Zone 👣 On our Round-Up with Sarah Ragan, COC, CPC, CPMA, CRC, CFPC, AAPC Approved Instructor, she mentioned how when you decide to step out of your comfort zone, that’s when your career really begins to take off! 🛫 It may seem scary especially when you’re used to something,🤔 but it will open a floodgate of new and better opportunities for you so give it a try! 🌊 We also talk about how you should be giving back after you receive help from someone else. 👋🫵 Let's say you need help with your job, once you receive that help, you can then help someone else with the same issue! 🤝 Giving back and stepping out of your comfort zone are great ways to open up new opportunities! 🎢🦋 👀 To watch the full Round-Up video with Sarah, click the link below! 👇 Be Renown, Bertram 🔔 Like | Comment | Share 🔔 #medicalcoding #healthinformation #comfortzone

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HOW TO SAVE THE VA $31.1 BILLION Between 2013 and 2025, spending on medical care for veterans surged by nearly 95%, from $68.4 billion to $135 billion. Currently, the VA is grappling with a significant budget deficit, estimated at $6.8 billion. This deficit partly stems from the influx of over 800,000 new enrollees following the passage of the PACT Act. Additionally, pharmaceutical costs have risen by $2 billion in the past year, mirroring trends in other healthcare organizations. However, the core issue lies in the VA’s inability to address complex and politically sensitive challenges that could substantially reduce costs. These challenges are not insurmountable. Addressing them would not only save taxpayers billions of dollars but also improve the system’s efficiency and effectiveness for veterans. Moreover, these changes are crucial to ensuring the long-term sustainability of this vital system, fulfilling our commitment to those who have served and sacrificed. In the detailed analysis attached, I outline practical solutions to achieve these savings. Below is a summary of 11 key areas for cost reduction: 1. Public-Private Partnership Construction – $3.0 billion 2. Standardization of Care – $5.6 billion 3. VA/DoD Sharing – $3.4 billion 4. Care Coordination and Interoperability – $3.3 billion 5. Nursing Retention – $1.5 billion 6. Technology Optimization – $2.8 billion 7. Medicare Subvention – $7.0 billion 8. Long-Term Care Savings – $1.0 billion 9. Alternative Sites of Care – $1.1 billion 10. Prevention and Chronic Illness Management – $1.4 billion 11. Value-Based Contracting – $1.0 billion Total Savings: $31.1 Billion By tackling these issues head-on, we can ensure a more efficient and effective VA system, safeguarding its future and honoring our commitment to America’s veterans. #veteransaffairs #government #governmentefficiency #costsavings https://lnkd.in/ei9--gtn

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Good news for EMS whole blood programs! CMS has released the advance text of a Proposed Rule in which Whole Blood Transfusion (WBT) Therapy would be added as an AL2-level skill under the Medicare Ambulance Fee Schedule. The current definition of ALS2 includes the administration of one or more of seven specific advanced interventions (such as manual defibrillation, endotracheal intubation, etc.) The new CMS Proposed Rule would add “administration of low titer O+ whole blood transfusion” as the 8th specific ALS2-level qualifying intervention to the current list, which is found in the CMS regulations at 42 CFR §414.605. CMS' recognition of whole blood as an important, emerging and evidence-based prehospital therapy is laudable. More EMS systems are utilizing whole blood in the field for trauma patients, and for years many systems have permitted EMS practitioners to monitor patients receiving whole blood or blood products during interfacility transports. CMS will be opening a comment period on the Proposed Rule through September 9, 2024. One issue on which CMS is specifically requesting comments is whether alternative blood products (such as plasma or PRBCs – packed red blood cells). Currently, the CMS proposal would not include alternative blood products in the ALS2 definition. https://lnkd.in/dseWMCnp

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As state chapters of NAMSS prepare for their annual conferences, consider adding Medical Licensing topics for your members. WHY? State chapters of the National Association Medical Staff Services (NAMSS) should consider offering medical licensing topics to their members for the following reasons: 1. Enhancing Professional Expertise Medical licensing is a critical aspect of credentialing, a core responsibility for NAMSS members. Offering education on this topic equips members with: *A comprehensive understanding of licensing processes, requirements, and timelines. *Insights into multi-state licensing (e.g., Interstate Medical Licensure Compact) and its impact on healthcare operations. *Knowledge of best practices for navigating challenges like delays, verifications, and renewals. 2. Supporting Organizational Compliance By mastering medical licensing intricacies, medical staff professionals can help their organizations: *Avoid compliance risks associated with expired or improperly managed licenses. *Streamline the credentialing process, ensuring physicians are ready to practice without delays. *Improve audit preparedness by implementing consistent licensing documentation practices. 3. Addressing Workforce Challenges As healthcare organizations face physician shortages and an increasingly mobile workforce, efficient licensing processes are crucial. Education on licensing topics can help NAMSS members: *Expedite onboarding for new providers. *Support locum tenens physicians or telehealth practitioners who need multi-state licenses. *Enhance their ability to assist providers in maintaining active, up-to-date credentials. 4. Professional Development Opportunities Licensing education provides a chance for NAMSS members to: *Expand their skillsets, making them more valuable to their organizations. *Earn continuing education credits (CEUs) to maintain NAMSS certifications like CPMSM and CPCS. *Network with peers and licensing experts to share experiences and solutions. 5. Responding to Industry Trends The medical licensing landscape continues to evolve with changes such as: *The growth of telemedicine, requiring licensing across multiple jurisdictions. *State-specific licensing reforms and the adoption of the Interstate Medical Licensure Compact. *Increasing demand for fast-tracked licensing processes to meet healthcare demands. By addressing these topics, NAMSS state chapters can position themselves as leaders in the industry, providing relevant and actionable education that directly impacts the success of their members and the organizations they serve. #credentialing #licensing #enrollment

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Addressing the Knowledge Gap in Civilian Healthcare for Post-9/11 Veterans is key educational pillar within HunterSeven Foundation Recent findings underscore that many civilian providers lack essential knowledge in critical areas such as war-related illnesses, traumatic brain injuries, and the psychological impacts of military service. This deficiency not only places veterans at risk of misdiagnosis and delayed treatment but also exposes them to the dangers of anchoring bias—where providers may prematurely fixate on mental health diagnoses, overlooking severe physical health concerns like cancers linked to military exposures. As the veteran population grows, the need for evidence-based, culturally competent healthcare becomes more urgent. It’s time to bridge this knowledge gap by integrating comprehensive military health education into civilian healthcare training and practice. While the mental health burden experienced by post-9/11 veterans is well-recognized, it has not been acknowledged as a potential barrier to accessing healthcare. With cancers being more prevalent in younger veterans of the post-9/11 era, mental health concerns and other comorbidities can present as "psychosomatic," potentially interfering with early cancer identification and treatment. Our study showed that 92% of civilian provider respondents believed mental health concerns were the most frequently occurring issues in post-9/11 veterans, and 72% of those providers believed that post-9/11 veterans routinely experience psychosomatic (mental health-related, physical) symptoms. This focus on mental health places minimal concern on the actual physical health, risking delayed diagnoses of severe conditions like cancer. The consequences are clear: civilian providers may inadvertently contribute to prolonged diagnoses and suboptimal care without targeted education and training. Read the publication on JMVFH - The Journal of Military, Veteran and Family Health - https://lnkd.in/gPM2a-XY Special thanks to the RAND team, Carrie Farmer and Terri Tanielian for starting the conversation.

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This is remarkable, a 30% jump in anesthesia (CRNA specifically) compensation and over the same period and 8% drop and reimbursement from the single largest payor. Same dynamic for physician compensation. It is no surprise that Anesthesia services are experiencing extreme volatility. It doesn’t matter if it’s internal or external. If that service line is not maximizing optimization on the provider delivery model, OR scheduling, pipeline, utilization, and development, not only does that threaten the viability of the service line, and all those that are related, it can be catastrophic for struggling facilities. Most facilities I see are doing this to a limited degree, very few are doing it well. https://lnkd.in/ergWyDrc.

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It is great to see mental health being prioritized in operational environments. https://lnkd.in/e2uGVZNX

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🌟 Whether you’ve determined now is the time for you to begin the process toward FACHE or you’re still deciding, the next stop on your journey is our FACHE Overview Webinar. This webinar is free for you to attend but it requires registration. Learn more and save your place here: https://bit.ly/3MkxxT8

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***Partnership Announcement*** Pediatric Resource Group (PRG) is excited to partner with Libman Education, one of the most trusted resources for training of hospital coding, CDI, and HIM professionals, to offer our Pediatric CDI Educational Series. The Pediatric CDI Educational Series has over 35 on-demand videos created by CDI expert pediatricians and geared towards coders, CDI professionals and clinical staff with the following objectives: -Understand inpatient pediatric conditions to identify all query opportunities -Describe documentation’s impact on severity adjustment, quality metrics, expected length of stay (LOS), & hospital payment -Review CDI processes, policies, metrics, and the CDI physician champion role This tool is a great supplement to our "Pediatric by PRG" module in the Pinson & Tang CDI Pocket Guide. #CDI #pediatrics #clinicaldocumentation https://lnkd.in/gewSdrAr

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Significant and Immediate Jeopardy Deficiencies in New Jersey from the Latest CMS Data…   F 808 Level J - Failure to ensure that the appropriate ordered liquid consistency was provided to a resident who was at high risk for aspiration. F 689 Level J - Failure to supervise and secure two exit-seeking residents, one with sever cognitive impairment and the other with discontinued out-of-pass privileges, resulting in their elopement. F 688 Level G - Failure to identify and prevent the worsening of a contracture in a resident's right hand, no intervention in place. F 812 Level F - Failure to maintain proper kitchen sanitation practices and clean equipment; failure to store food in a safe manner; failure to maintain nursing unit kitchenettes in a sanitary manner. F 760 Level F - Failure to ensure a resident received the correct dosage of prn narcotic medication, leading to multiple instances of administering the wrong dose, due to the presence of both discontinued and current medication cards in the narcotic drawer. F 755 Level F - Inaccurate documentation of the removal of a controlled substance and discrepancies in the medication count. F 922 – Level F - Failure to maintain adequate emergency water supply. F 880 Level E – Failure to ensure staff wore appropriate PPE for residents on Enhanced Barrier Precautions/lacking EBP sign and PPE bin at their door. F 880 Level E - Failure to ensure infection control practices were adhered to due to incorrect signage posted on resident door. Thank you Team Assisto ! https://lnkd.in/ekAZY8-5

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This article by Erin Carn-Bennett, MSN, RN will explore three suggested high fidelity pediatric clinical simulation scenarios that includes the scenario stem and also considerations for stages of scenario and delivery. Read more: https://lnkd.in/gz23vTRa #HealthcareSimulation #ClinicalSimulation #MedicalSimulation #PediatricSimulation International Pediatric Simulation Society

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Who's going to buy Steward's remaining Massachusetts hospitals? Physicians can't own hospitals. Legislators have turned up the heat and regulatory scrutiny of PE and VC-backed healthcare (in large part because of Steward's bad apples). Smaller independent community hospitals (of which there are now few) are already struggling financially. Enter large, market dominant health systems? The state has made it clear it's not thrilled about Mass General Brigham owning more hospitals. (Instead, they've spun up outpatient centers in HNW areas and turned their attention to neighboring states). As a condition of approving its merger, Beth Israel Lahey Health agreed to a 7-year moratorium on cost increases among other concessions. That's set to expire in the next year or so. Do we really want more health system consolidation? (Studies would suggest the answer is "no" if you want lower prices, demonstrably better care and access, and fewer employed physicians). So, who's left? Are we willing to think a bit differently? Explore alternative options? Allow physicians or physician groups with business partners to make a go of it? (The horror, the horror). Can we admit that regulatory grandstanding has created as many, if not more, problems than it has solved? This is an opportunity to be a little bold. We shouldn't abide conflicts of interest or allow free reign for fraud and abuse. Oversight and transparency are paramount. But we can use a deft touch instead of a heavy hand. We can support innovation, not stifle it. This goes not just for Steward, but for efforts across the country to tackle hard problems by taking a different angle. Otherwise, get ready for more of the same. Same wolf, different clothing. #health #healthcare #medicine

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“I do believe that having the right physical environment helps the team function better and deliver better care.” - Melvin Blanchard, M.D., FACP, Chair of Medicine, Greater Baltimore Medical Center (GBMC HealthCare) The HCM team prioritized patient comfort in the design of this renovation and expansion. Thoughtful elements such as natural light, intuitive navigation, larger patient rooms, and cozy visitor seating areas all help to reduce the stress of patients, visitors, and staff alike. Read more about the GBMC Promise Project in this edition of Health Facilities Management by the American Society for Health Care Engineering (ASHE): https://lnkd.in/epD7KbHV

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--Not all ERs/Hospitals are the same.-- #3 in "Things ER Docs Wish Patients Knew" Disclaimer: In an emergency situation, call 911 or go to the nearest hospital immediately. Having said that, there are often times where you are driving yourself/your child to the ER and you have several nearby to choose from. Something many patients don't realize, and haven't researched, is that not all ERs are the same. While all ERs are trained/equipped to deal with emergencies as best they possibly can, training and resources can vary wildly between ERs/hospitals. As a parent, you should know where the nearest pediatric ER is. If time isn't of the essence, when your child needs the ER you should choose to go here. Why? The physicians and nurses at peds ERs often have additional training specifically with regard to children, they almost definitely have more experience with kids than the clinicians at general ERs, the environment is often much more conducive and friendly to kids (no loud intoxicated/mentally-ill adult patients in the next room over), if admission or a specialist is needed they often have an inpatient peds unit and a broad choice of peds specialists. So...again, when it's an emergency and there is no time to waste, go to the nearest ER (preferably by ambulance) as they will be fully capable of addressing the emergency and if needed, can transfer you later when stabilized, when you have a choice though, you'd be foolish to take your child anywhere but to a peds ER. Another example relates to the availability of specialists. e.g. If you are going to an ER with an eye complaint (beyond the basics, i.e. pink eye), and you have your choice between multiple ERs, go to the one that has an ophthalmologist available should you need one. Often this means an academic center as these tend to have the largest variety of specialists. - Before you need the ER, take the time to research where your nearest pediatric ER is, where the nearest trauma center is, where the nearest hospital with ophthalmology consultation in the ER is, where the nearest academic hospital is, etc. - If you can safely do so, go the hospital most likely to provide you the best possible care. 𝘕𝘰 𝘮𝘢𝘵𝘦𝘳𝘪𝘢𝘭 𝘪𝘯 𝘵𝘩𝘪𝘴 𝘱𝘰𝘴𝘵 𝘪𝘴 𝘪𝘯𝘵𝘦𝘯𝘥𝘦𝘥 𝘵𝘰 𝘣𝘦 𝘢 𝘴𝘶𝘣𝘴𝘵𝘪𝘵𝘶𝘵𝘦 𝘧𝘰𝘳 𝘱𝘳𝘰𝘧𝘦𝘴𝘴𝘪𝘰𝘯𝘢𝘭 𝘮𝘦𝘥𝘪𝘤𝘢𝘭 𝘢𝘥𝘷𝘪𝘤𝘦, 𝘥𝘪𝘢𝘨𝘯𝘰𝘴𝘪𝘴 𝘰𝘳 𝘵𝘳𝘦𝘢𝘵𝘮𝘦𝘯𝘵. 𝘈𝘭𝘸𝘢𝘺𝘴 𝘴𝘦𝘦𝘬 𝘵𝘩𝘦 𝘢𝘥𝘷𝘪𝘤𝘦 𝘰𝘧 𝘺𝘰𝘶𝘳 𝘱𝘩𝘺𝘴𝘪𝘤𝘪𝘢𝘯 𝘰𝘳 𝘰𝘵𝘩𝘦𝘳 𝘲𝘶𝘢𝘭𝘪𝘧𝘪𝘦𝘥 𝘩𝘦𝘢𝘭𝘵𝘩 𝘤𝘢𝘳𝘦 𝘱𝘳𝘰𝘷𝘪𝘥𝘦𝘳 𝘸𝘪𝘵𝘩 𝘢𝘯𝘺 𝘲𝘶𝘦𝘴𝘵𝘪𝘰𝘯𝘴 𝘺𝘰𝘶 𝘮𝘢𝘺 𝘩𝘢𝘷𝘦 𝘳𝘦𝘨𝘢𝘳𝘥𝘪𝘯𝘨 𝘢 𝘮𝘦𝘥𝘪𝘤𝘢𝘭 𝘤𝘰𝘯𝘥𝘪𝘵𝘪𝘰𝘯 𝘰𝘳 𝘵𝘳𝘦𝘢𝘵𝘮𝘦𝘯𝘵 𝘢𝘯𝘥 𝘣𝘦𝘧𝘰𝘳𝘦 𝘶𝘯𝘥𝘦𝘳𝘵𝘢𝘬𝘪𝘯𝘨 𝘢 𝘯𝘦𝘸 𝘩𝘦𝘢𝘭𝘵𝘩 𝘤𝘢𝘳𝘦 𝘳𝘦𝘨𝘪𝘮𝘦𝘯, 𝘢𝘯𝘥 𝘯𝘦𝘷𝘦𝘳 𝘥𝘪𝘴𝘳𝘦𝘨𝘢𝘳𝘥 𝘱𝘳𝘰𝘧𝘦𝘴𝘴𝘪𝘰𝘯𝘢𝘭 𝘮𝘦𝘥𝘪𝘤𝘢𝘭 𝘢𝘥𝘷𝘪𝘤𝘦 𝘰𝘳 𝘥𝘦𝘭𝘢𝘺 𝘪𝘯 𝘴𝘦𝘦𝘬𝘪𝘯𝘨 𝘪𝘵 𝘣𝘦𝘤𝘢𝘶𝘴𝘦 𝘰𝘧 𝘴𝘰𝘮𝘦𝘵𝘩𝘪𝘯𝘨 𝘺𝘰𝘶 𝘩𝘢𝘷𝘦 𝘳𝘦𝘢𝘥 𝘰𝘯 𝘵𝘩𝘪𝘴 𝘸𝘦𝘣𝘴𝘪𝘵𝘦.

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