Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid
  • Challenges, Successes of First-Year Shared Savings ACOs

    September 23, 2016 - Participants in the Medicare Shared Savings Program (MSSP) already familiar with physician practice transformation were more likely to earn shared savings payments, which should lead the Centers for Medicare & Medicaid Services to focus on first-time accountable care organizations. That's the suggestion from the authors of a recent report in the American Journal of Managed Care —...

  • How Pioneer ACOs Earn Shared Savings, Improve Care Quality

    September 21, 2016 - Massachusetts-based Atrius Health successfully managed several care quality improvements over the previous year and earned both the recognition of CMS and a portion of shared savings as a participant in the Pioneer ACO Model program. In August, CMS announced that two Medicare accountable care organization (ACO) programs – the Medicare Shared Savings Program and the Pioneer ACO model...

  • Value-Based Care Analytics Help Cut Healthcare Costs in Utah

    September 15, 2016 - By implementing a data analytics tool that integrates spending and patient outcome data, a Utah-based healthcare system reduced spending by up to 11 percent on three clinical improvement projects, including joint replacement, laboratory utilization, and sepsis management improvement initiatives. The findings published in the Journal of the American Medical Association showed how presenting...

  • Using Data Analytics to Decrease Claims Denials, Boost Revenue

    September 12, 2016 - Claims denials typically represent one of the largest revenue cycle bottlenecks in most healthcare organizations.  However, slowing down to determine why claims are being denied hasn’t traditionally been an option. The light at the end of the tunnel isn’t due to a slower pace - rather, revenue cycle leaders have started to leverage data analytics tools to drive toward simplifying...


Today's Top Stories

House Reps Introduce Medicare ACO Improvement Legislation

House representatives Diane Black (R-TN) and Peter Welch (D-VT) introduced a bill last week that would change the rules for Medicare accountable care organizations (ACOs). The ACO Improvement Act of 2016 contains reforms for Medicare Shared Savings...

Few Docs Familiar with MACRA, Transitioning to Value-Based Care

Only 20 percent of physicians reported that they are very or somewhat familiar with MACRA, according to a recent survey from the Physicians Foundation and Merritt Hawkins, and the majority of respondents do not currently have a large portion...

Challenges, Successes of First-Year Shared Savings ACOs

Participants in the Medicare Shared Savings Program (MSSP) already familiar with physician practice transformation were more likely to earn shared savings payments, which should lead the Centers for Medicare & Medicaid Services to focus on...

85% of Orgs Looking to Replace Revenue Cycle Management Systems

Eighty-five percent of provider organizations, hospitals, and physician practices are currently seeking to replace their healthcare revenue cycle management systems or are deciding if it is time to switch, according to a new survey from Black...

Provider Org Pays $3M for Violating Medicare Fraud Resolution

Kindred Healthcare, Inc., the country’s largest provider of post-acute care, recently paid more than $3 million for failing to comply with a Medicare fraud resolution agreement. It represents the largest penalty ever doled out by the Office...

Court Denies HHS Wish to Delay Medicare Appeals Backlog Case

A federal district court recently denied a request from the Department of Health and Human Services (HHS) to postpone proceedings on a Medicare appeals backlog case until Sept. 30, 2017, according to the court’s decision. US District Judge...

How Pioneer ACOs Earn Shared Savings, Improve Care Quality

Massachusetts-based Atrius Health successfully managed several care quality improvements over the previous year and earned both the recognition of CMS and a portion of shared savings as a participant in the Pioneer ACO Model program. In August,...

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