Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid
  • How Emergency Providers Can Adopt Alternative Payment Models

    August 23, 2016 - With many value-based care initiatives aiming to reduce costly emergency room visits, some emergency departments are finding it increasingly difficult to engage with alternative payment models, according to a report in the American Journal of Managed Care. “Ultimately, the goal of payment and delivery reforms in emergency care is about collaborating with the ED to improve population...

  • How the Affordable Care Act Impacted Healthcare Revenue Cycle

    August 18, 2016 - From the transition to value-based care to the rise in patient consumerism, the Affordable Care Act has significantly changed the healthcare revenue cycle management landscape since its passage in 2010. Healthcare providers restructured how they deliver care and collect payments as well as refocused their revenue cycles to maximize profit in a value-based industry. While some physicians have...

  • Strong Compliance Programs Key to Avoiding Healthcare Fraud

    August 17, 2016 - Preventing and catching healthcare fraud schemes has recently jumped to the forefront of many public and private payer programs that are designed to reduce unnecessary healthcare spending. The Department of Health and Human Services (HHS) announced recently that it facilitated the largest healthcare fraud takedown in the federal agency's history. HHS, in collaboration with the Department...

  • Exploring the Role of Supply Chain Management in Healthcare

    August 5, 2016 - Cutting healthcare costs has become a mantra for many hospitals and physician practices, especially as payers start to tie claims reimbursement amounts to quality and cost performance. Many organizations have looked to the billing and services portion of the revenue cycle for budget decreases, but others have started to examine their healthcare supply chain management. The supply chain generally...


Today's Top Stories

Pharma Payments Influence Prescription Drug Spending

Payments from pharmaceutical manufacturers may be more influential on physician prescribing habits than concerns over the rise in prescription drug spending, according to a recent study in the BMJ. Researchers found that small payments from pharmaceutical...

How Emergency Providers Can Adopt Alternative Payment Models

With many value-based care initiatives aiming to reduce costly emergency room visits, some emergency departments are finding it increasingly difficult to engage with alternative payment models, according to a report in the American Journal of...

CMS Prepares Providers for End of ICD-10 Coding Flexibilities

Starting on October 1, CMS plans to thaw the freeze on ICD-10 implementation by adding more codes and allowing review contractors to deny claims based on level of specificity. To help healthcare providers prepare for updates to ICD-10 coding...

Patients Led to Private Plans to Boost Claims Reimbursement?

The federal agency is investigating whether some healthcare providers or provider-affiliated organizations are encouraging individuals eligible for Medicare and/or Medicaid to enroll in individual market plans under the Affordable Care Act in...

HHS Awards $100M to Health Centers for Quality Improvement

The Department of Health and Human Services recently granted over $100 million in awards to 1,304 health centers across the nation to help improve care quality and boost primary care services, according to the federal department’s website....

$17B Increase in Medicare Part D Prescription Drug Spending

Prescription drug spending under the Medicare Part D program increased by $17 billion between 2013 and 2014, representing a 17-percent increase, according to new CMS data. While the federal reported a significant boost in prescription drug spending...

How the Affordable Care Act Impacted Healthcare Revenue Cycle

From the transition to value-based care to the rise in patient consumerism, the Affordable Care Act has significantly changed the healthcare revenue cycle management landscape since its passage in 2010. Healthcare providers restructured how they...

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