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

Features

Understanding the Quality Payment Program’s Advanced APM Track

From bundled payments to accountable care organizations, alternative payment models (APMs) are not new to healthcare providers. But the final MACRA implementation rule created a new subset of Advanced APMs, which could bring providers more revenue under the Quality Payment Program. Eligible clinicians in the Quality Payment Program have two participation options: the Merit-Based Incentive...


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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...

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...

Can Application Programming Interfaces Inspire a Better EHR?

HealthITAnalytics Almost everybody can recall being told the stories of Archimedes in the bath and Isaac Newton under the apple tree experiencing spontaneous moments of ingenuity and inspiration that irrevocably changed how scientists – and everyone who...

The Evolving Role of mHealth in Medication Management and Adherence

mHealthIntelligence mHealth offers many unique methods for helping patients take their medicine. And with a healthcare industry seeing non-adherence rates of as high as 50 percent and annual costs of between $100 billion and $300 billion, doctors are taking notice....

Top Strategies for Collecting Patient Financial Responsibility

PatientEngagementHIT Patient financial responsibility – or the amount of out-of-pocket healthcare costs patients incur – has been increasing in recent years, presenting a new foil to the patient experience. Providers must both adjust to consumer-centered...

Data Security Considerations in Healthcare Interoperability

HealthITSecurity While more healthcare organizations are utilizing electronic health records (EHRs) and adding to the increase in healthcare interoperability finding a health IT option that provides better patient care and keeps PHI secure is not always easy....

How Virtual Desktop Infrastructure Supports Patient Care

HITInfrastructure Value-based care initiatives have pushed healthcare organizations to embrace more advanced technology as priorities have shifted from security concerns to how to access information securely, quickly, and conveniently. Virtual desktop infrastructure...

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