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

Revenue Cycle Management Healthcare News

NAM Advises Leaders to Prioritize Value-Based Purchasing Reform

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In a new report, the National Academy of Medicine (NAM) named value-based purchasing as one of four action priorities for healthcare stakeholders in 2017. To implement more value-based purchasing models, NAM suggested that stakeholders focus...

Managing Healthcare Costs, Data Analytics Top C-Suite Priorities

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Under the Trump administration, the healthcare industry is bracing for some significant policy changes, such as a potential Affordable Care Act repeal. Despite the political change, healthcare executives still plan to make healthcare cost management...

Physician Shortage Projected to Grow to 104K Providers by 2030

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The physician shortage is projected to grow to up to 104,900 providers by 2030, new research from the Association of American Medical Colleges (AAMC) revealed. The projected physician shortage increased from an estimated shortfall of up to 90,000...

MedPAC Targets Post-Acute Care for Healthcare Payment Reform

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In its March 2017 report to Congress, the Medicare Payment Advisory Commission (MedPAC) pinpointed post-acute care for healthcare payment reform after Congressional and CMS inaction resulted in as much as $11 billion in lost savings since 2009....

CMS Delays Rollout of Cardiac, Ortho Bundled Payment Programs

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CMS is pushing back the start date for a number of its bundled payment programs in an effort to provide additional time to review and prepare for the initiatives. In a notice posted in the Federal Register, CMS has issued three-month delays for...

Tracking Key Hospital Revenue Cycle Metrics to Up Profitability

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As the value-based reimbursement transition rolls on, many hospitals have adopted “If you can measure it, you can manage it” as their new motto. But how can providers and executives measure hospital revenue cycle management? Hospital...

MGMA to CMS: Notify Clinicians About MIPS Eligibility ASAP

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The Medical Group Management Association (MGMA) recently called on CMS Administrator Seema Verma to immediately release Merit-Based Incentive Payment System (MIPS) eligibility notifications as well as approved vendor lists and hospital or patient-facing...

Hospitals Seek Independent Docs for Referrals, Healthcare Revenue

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A recent SCI Solutions survey found that 58 percent of independent providers do not have one or more preferred referral hospital partners, suggesting a major healthcare revenue opportunity for health systems and hospitals. Out of the 549 independent...

52% of Practices Use Various Reminders to Stop Patient No-Shows

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To prevent patient no-shows, a recent Medical Group Management Association (MGMA) poll showed that providers are using a variety of communication methods to protect their healthcare revenue from missed appointments. The recent survey of 1,279...

Healthcare Spending Varies More by Provider Than Hospital

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A recent JAMA Internal Medicine study uncovered that healthcare spending varied more across individual providers than across hospitals. Based on Medicare data on hospitalized beneficiaries from 2011 to 2014, researchers from several Boston health...

Senate Confirms Seema Verma as Next CMS Administrator

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In a 55 to 43 vote yesterday, the Senate confirmed Seema Verma as the next CMS Administrator, according to a New York Times article. Verma, the founder, president, and CEO of a health policy consulting firm, will be charged with managing...

AHA, FAH Oppose Proposed Physician Self-Referral Law Changes

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The American Hospital Association (AHA) and the Federation of American Hospitals (FAH) recently urged lawmakers to oppose a proposed bill that would extend physician self-referral allowances to physician-owned hospitals. In late February, House...

Diabetes Clinic Lowers Healthcare Costs More Than PCP Visits

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A California-based health system reduced healthcare costs by 2.5 percent more for diabetes patients by implementing a clinic that brings endocrinologists and pharmacists together to better manage medically complex diabetic patients, a recent...

Using Bundled Payments to Pay Providers for mHealth Nudges

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Many providers have been able to extend their reach outside of their office by using mHealth technologies that encourage patients to improve their own health outcomes through nudges. However, payment structures for the healthcare encounters have...

Top 5 Ingredients of a Successful Alternative Payment Model

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Alternative payment models tie provider reimbursement to quality and cost performance. Besides their foundational function, though, each model has its own rules pertaining to financial incentive structures, quality measurements, and patient populations...

Top 4 Claims Denial Management Challenges Impacting Revenue

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For most healthcare organizations, claim denials are a normal, if not a frequent, occurrence. While very few can boast that their denial rates are close to zero, many providers face a number of challenges with implementing an effective claims...

46% of Providers Unsure About Value-Based Purchasing Impact

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Value-based purchasing is not a new term for many providers, yet 46.4 percent of healthcare providers and leaders are still unsure how the shift away from fee-for-service payments will impact their revenue cycles, a recent Physicians Practice...

Health IT, Care Navigators Most Effective at Lowering Costs

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While countless strategies are out there for making care delivery more efficient, a recent Health Affairs study revealed that interventions that use health IT and community health workers realized the greatest cost savings. Researchers examined...

Higher Hospital Costs Stem from ICU Overuse for Some Conditions

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Healthcare providers may be able to decrease hospital costs by avoiding ICU admissions for some patients with chronic obstructive pulmonary disease (COPD), exacerbation of heart failure (HF), and acute myocardial infarction (AMI), a recent American...

274 Orgs Calls on CMS to Add Medicare Advantage Advanced APMs

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CMS should develop financial incentives comparable to those in the Quality Payment Program’s Advanced Alternative Payment Model (APM) track for providers who assume financial risk under Medicare Advantage plans, CAPG and 273 other healthcare...

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