Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Features

Exploring Two-Sided Financial Risk in Alternative Payment Models

As value-based care becomes the name of the game in healthcare, public and private payers are pushing providers to take on more financial accountability for their services through alternative payment models. In a fee-for-service world, providers received reimbursement for every test or procedure they performed without being penalized or rewarded if their services impacted patient outcomes...


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Top Revenue Cycle Management Vendors and How to Select One

As value-based reimbursement models, such as the upcoming Quality Payment Program, break down the walls between care quality and healthcare payments, more providers have set their sights on implementing vendor-sponsored revenue cycle management...

What a Trump Presidency Means for Value-Based Care and the ACA

Love it or loathe it, the United States is headed for four years of drastic policy changes under a Donald Trump administration, giving lawmakers another good chance to repeal, replace, or revise the Affordable Care Act. The landmark healthcare...

How to Maximize Revenue with Improved Claims Denials Management

Claims denials may be a part of life for healthcare revenue cycle managers, but a prevention-focused denials management strategy may be able to significantly reduce the number of times billing staff are faced with unpaid claims. Recent healthcare...

CMS Timelines for Stage 3 Meaningful Use, MACRA Implementation

For Medicare providers, CMS has set the pace for quality improvements and healthcare payment reform through Stage 3 Meaningful Use and the Quality Payment Program (under MACRA implementation). The programs are designed to put providers on track...

Understanding the Value-Based Reimbursement Model Landscape

In January 2015, the Department of Health and Human Services (HHS) announced that it intends to link half of all traditional Medicare payments to a value-based reimbursement model by the end of 2018.  The announcement, followed...

Key Ways to Boost Collection of Patient Financial Responsibility

Ever since the Affordable Care Act was passed in 2010, more providers are experiencing a shift in healthcare revenue sources, especially as patient financial responsibility increases. While hospitals and physician practices traditionally communicated...

Preparing the Healthcare Revenue Cycle for Value-Based Care

Not only do value-based care models aim to make healthcare providers more accountable for the services they provide to patients, but they are also designed to shift financial accountability away from payers to healthcare organizations. However,...

What Is Healthcare Revenue Cycle Management?

While hospitals, small practices, and larger healthcare systems are known for saving lives and treating patients, every healthcare organization needs to develop successful processes and policies for staying financially healthy. That is where...

What Is Value-Based Care, What It Means for Providers?

Value-based care is a form of reimbursement that ties payments for care delivery to the quality of care provided and rewards providers for both efficiency and effectiveness. This form of reimbursement has emerged as an alternative and potential...

Using Revenue Cycle Analytics for Effective Value-Based Care

The hospital industry has been experiencing a number of challenges in recent years due to the payment reforms coming from the Centers for Medicare & Medicaid Services (CMS) and commercial health payers. There has been a much greater push...

What We Know About Value-Based Care Under MACRA, MIPS, APMs

The Medicare Access and CHIP Reauthorization Act of 2015 has many parts tied to Medicare and other federal health plan beneficiaries, but first and foremost it is a bill that brings an end to the sustainable growth rate and a beginning to new...

Key Ways to Improve Claims Management and Reimbursement in the Healthcare Revenue Cycle

Reimbursement is changing in healthcare. Even before elements of the Affordable Care Act began to go into effect, a growing focus on value- based care versus volume has led many healthcare organizations and providers to consider accountable...

Why Healthcare Needs Value-Based Supply Chain Management

Healthcare supply chain — the holistic flow of relationships between suppliers and customers — is about efficiently delivering low cost care as goods and supplies, such as a pair of doctor’s gloves, move from point of purchase...

Judy Faulkner: Epic is Changing the Big Data, Interoperability Game

HealthITAnalytics In the flashy, crowded, dizzyingly large vendor halls at the annual HIMSS Conference and Exhibition, attendees tend to find their way around by using some of the biggest, tallest, or most unique booths as a compass.  A left at Cerner; a...

How Do Patient Portals and Personal Health Records Differ?

PatientEngagementHIT Patient portals and personal health records (PHRs) have both received considerable praise for their role in increasing patient engagement. However, distinguishing between the two forms of health IT tools can often be difficult, due to nebulous...

Examining the Rocky Road to Telehealth Parity

mHealthIntelligence Telehealth advocates have long argued that online and digital healthcare should be treated the same as in-person healthcare. But the call for parity isn’t so simple. Parity in telehealth is approached on two levels: Service and payment....

Considerations for Deploying Healthcare Wireless Networks

HITInfrastructure Wireless networks are the lifeblood health IT infrastructure, but developing and deploying reliable WiFi to support present and future IT initiatives can be a challenge.   Clinicians and staff are becoming dependent on mobile and connected...

How FDA Medical Device Cybersecurity Guidance Affects Providers

HealthITSecurity With the continued push for interoperability and integration of EHRs into daily use, connected medical devices are quickly becoming more common tools for healthcare providers. However, similar to the way computer networks and systems can become...

Health Information Governance Strategies for Unstructured Data

HealthITAnalytics While electronic health records still have the potential to standardize care by enabling advanced analytics and informing clinical decision-making, much of the data held within these systems – and a large proportion of the data used in...

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