Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid
  • CMS: Providers Need Data Access for Value-Based Reimbursement

    January 18, 2017 - Value-based reimbursement success rests on providing clinicians with convenient and increased access to meaningful data, the leaders of the Office of the National Coordinator (ONC) and CMS stated in a recent official CMS blog post. “Data is the lifeblood of the value-based payment environment,” Vindell Washington, MD, the National Coordinator for the ONC and Andy Slavitt, CMS Acting...

  • Addressing Social Risk in Medicare Value-Based Reimbursement

    January 12, 2017 - Hospitals that disproportionately treat patients with social risk factors, such as low income and race, may be unfairly penalized under some Medicare value-based reimbursement programs. But the National Academies of Science, Engineering, and Medicine (NASEM) recently suggested a method that would incorporate social risk factors into value-based reimbursement to make penalty determinations...

  • ACO Incentives, Coordination Improve Complex Pediatric Care

    January 10, 2017 - Children with medical complexities, or children who require the highest level of service and support, are one of the most expensive pediatric patient populations. But provider collaboration and financial incentives through an accountable care organization (ACO) may be the ticket to lowering the population’s costs as well as improving their outcomes, Garey Noritz, MD, recently told RevCycleIntelligence.com...

  • How the 21st Century Cures Act Impacts Medicare Reimbursement

    January 5, 2017 - The 21st Century Cures Act may have been a landmark law for precision medicine, drug innovation, telemedicine, and mental health reform, but the law also contained several Medicare reimbursement policy changes set to take effect starting this year and into 2019. Among the major Medicare provisions in the act are site-neutral payment exceptions, socioeconomic adjustment for Hospital Readmissions...


Today's Top Stories

CMS: Providers Need Data Access for Value-Based Reimbursement

Value-based reimbursement success rests on providing clinicians with convenient and increased access to meaningful data, the leaders of the Office of the National Coordinator (ONC) and CMS stated in a recent official CMS blog post. “Data...

HHS Finalizes Solutions to Decrease Medicare Appeals Backlog

In effort to reduce the significant Medicare appeals backlog, the Department of Health and Human Services (HHS) recently finalized several appeals process changes. Major modifications included using precedential decision-making at the Departmental...

AAFP: Primary Care Undervalued in Medicare Reimbursement

CMS released updated physician fee schedule rates in November 2016, but the American Academy of Family Physicians (AAFP) recently contended that Medicare reimbursement rates for primary care providers are still lacking. In a letter to CMS, the...

All-Payer Alternative Payment Model Targets PA Rural Hospitals

A new six-year all-payer alternative payment model will focus on improving care quality and reducing healthcare costs at rural hospitals in Pennsylvania, CMS announced in a recent fact sheet. The CMS Innovation Center’s latest project,...

CMS Brings Integrated, Multi-Payer Claims Data Access to CPC+

In an official blog post, CMS recently touted its success with improving primary care provider productivity by giving practices in the Comprehensive Primary Care (CPC) program more multi-payer claims data access. The Medicare primary care program...

Electronic Claims Management Adoption to Save Providers $7.9B

Healthcare providers could save about $7.9 billion annually by switching to automated claims management processes, particularly for prior authorizations, remittance advices, and claim attachment submissions, according to the 2016 CAQH Index....

Do Pay-for-Performance Programs Improve Patient Outcomes?

Value-based reimbursement models that pay for performance modestly incentivized providers to stick to clinical guidelines, but they may not be linked to better patient outcomes, a recent Annals of Internal Medicine study indicates. The literature...

View all stories

X

Join 30,000 of your peers and get free access to all webcasts and exclusive content

Sign up for our free newsletter:

Our privacy policy

no, thanks