Hospitals must meet all criteria during the grant year to qualify. The grant year is September 1 – August 31. By meeting the criteria listed below your hospital demonstrates leadership, community, willingness to share with peers and a commitment to improvement. Award criteria is outlined below.
2024 – 2025 Grant Year Award Criteria
Performance Improvement Project Submission (will open late June)
Quality Program of the Year Submission (will open late June)
Mountainview Medical Center was recently awarded the Montana Rural Healthcare Performance Improvement Network’s Quality Program of the Year Award for its efforts in quality patient care.
As the revenue team was billing and examining lost revenue it was noted that Medicare labs and radiology exams were frequently being written off costing Mountainview Medical Center a significant amount of noncovered Medicare services each year. The reason for the write-off was because there was no Advanced Beneficiary Notice (ABN) being completed prior to completion of the tests. When the ABN does not get completed and Medicare deems the test as not medically necessary then the facility cannot bill the patient for the services provided.
After determining the necessity to obtain ABN’s they needed to determine which patients required the ABN and how to use their Electronic Medical Record (EMR) to its best ability to complete the ABN. The Informatics Nurse worked with their EMR vendor to learn the process so she could teach the clinic nurses and providers how to complete the ABN. She then assured all staff involved had the proper permissions within the EMR and developed step by step instructions on how to complete the ABN.
The quality metric was added to the Lab, Radiology, and Clinic QAPI scorecards to track ABN collection on all Medicare accounts each month, with a goal of 90% or better completion rate. Mountainview Medical Center was able to see a downward trend in each FY write off decreasing by approximately $8,000 from FY22 to FY24.
Contact Lindsay Konen at [email protected] or 406-457-8002.