help_outline Skip to main content
HomeNews List

News / Articles

Search News / Articles


Hospitals Tackle Unedited Copy/Paste
Published on: 1/27/2020
ACPA BOD member, Dr. Alvin Gore, illustrates his efforts in the 1/27/2020 edition of Report on Medicare Compliance (page 4).
A Novel Approach to Hospital Efficiency
Published on: 8/15/2018
The status of the post Affordable Care Act landscape, including the fate of the American Health Care Act and the Better Care Reconciliation Act, remains uncertain. Nevertheless, continuation of recent years’ overall healthcare trends seems assured. Guided by public policy, downward pressure on payments and resultant revenues will continue. Alternative payment schemes will be pursued with an emphasis on...
Region 4 CMS Input on Medicare Advantage Plans
Published on: 11/12/2019
The South Carolina Hospital Association (SCHA) and members recently met with Region 4 CMS to discuss CMS governance of Medicare Advantage (MA) Plans. This is an issue that has been discussed often in our Physician Advisor (PA) community. Concerns by PAs relate to prolonged observation requirements, delays in payment, volume of denials and incorrect clinical validation audit findings by MA plans. In order to get the issue of MA plan governance elevated, CMS needs...
Understanding the Clinical Diagnosis of Sepsis-3
Published on: 11/5/2018
ACPA President Dr. Edward Hu explains how lack of a SOFA score does not rule out sepsis.
Observing the Rules for Observation After Outpatient Surgery
Published on: 11/26/2018
ACPA board member Dr. Juliet Ugarte Hopkins provides some much-needed updating to a classic article from ACPA founding member Dr. Steve Meyerson originally printed before the Two-Midnight Rule.
Total Knee Arthroplasty Gets (Even More) Confusing
Published on: 11/14/2018
ACPA board member Dr. Juliet Ugarte Hopkins discusses how "Outpatient" does not mean "same-day.
HFMA Offers ACPA Member Discounts on Educational Activities
Published on: 9/8/2018
HFMA Business of Health Care ® Online Program
HFMA Revenue Cycle Conference, October 21-23, Denver CO
Physician Advisor: Critical Player in Payer Contracting
Published on: 9/27/2017
As the bridge between the frontline troops and the payers, Physician Advisors must be familiar with the terms of their facilities’ contracts and, preferably, involved in negotiation of their terms.
Physician Advisor Return on Investment Tool
Published on: 9/25/2017
Elizabeth Lamkin provides a great ROI tool that can be used to track return on a Physician Advisor Program.
Feather Ruffling and Trail Blazing Required:
Published on: 12/1/2016
Why your search for a physician advisor should not be internal

Now that most health systems are aware of the profound, positive impact a physician advisor can make in the case management, utilization, and clinical documentation improvement (CDI) arenas, hospitals are scrambling to find the perfect candidate. This search inevitably begins with one question: “Hire from within, or recruit an outsider?”
Five Steps To A Productive 2017
Published on: 2/1/2017
With the start of 2017, I thought I would present something completely unique and un-tried.

Reflections on lessons learned in 2016.
Collaboration with Your Contracting Office Provides the Rules for Status Games
Published on: 4/1/2017
Most of us understand the Medicare Two-Midnight Rule. Whether anticipation of two midnights of medically-necessary care in the hospital at the time of admission, or expectation of a second, medically-necessary midnight the day following admission after a first midnight has passed, we get it. For the most part, it’s become pretty engrained in our psyche.
Strengthening Physician Advisor Engagement in the CDI Process to Decrease Your Unanswered Query Rate
Published on: 4/1/2017
Comprehensive yet pertinent documentation is critical within the medical record. Far beyond coherent communication of data and insight between medical providers caring for a patient, good documentation also allows for accurate representation of patient severity in quality data, and appropriate coding, billing, and reimbursement.
Response to RFI for 2017 MAO Transformation Ideas
Published on: 4/24/2017
The American College of Physician Advisors (ACPA) appreciates the opportunity to respond to your RFI soliciting ideas to better achieve transparency, flexibility, program simplification, and innovation in the administration of Medicare Part C.
ACPA Response to 2018 IPPS Proposed Rule
Published on: 7/12/2017
In the 2017 Inpatient Prospective Payment System (IPPS) proposed rule (CMS-1655-P) the Centers for Medicare and Medicaid Services (CMS) requested input on ideas that would make regulations less burdensome and more transparent. We appreciate this effort. Our “all inpatient” proposal is aligned with these goals.
Physician Advisor Program Metrics
Published on: 7/2/2017
The success of Physician Advisor (PA) programs in quality improvement, margin protection and regulatory risk reduction has led to the identification of measureable metrics to evaluate and monitor a PA program. This article will provide an overview and examples of how to measure success and how to use metrics to sustain improvements.