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

Revenue Cycle Management Healthcare News

Unexpected Patient Financial Responsibility in 20% of ED Cases

by

Approximately 20 percent of hospital admissions stemming from an emergency department visit in 2014 led to unexpected patient financial responsibility in the form of surprise medical bills, a recent Health Affairs study reported. Using national...

CMS Unveils New Medicare APMs for Quality Payment Program

by

CMS finalized several new Medicare alternative payment models that will qualify for a five percent value-based incentive payment through the Quality Payment Program. The announcement contained bundled payment initiatives for cardiac and orthopedic...

AMGA: Drop Transition, Add MSSP Track for MACRA Implementation

by

With the Quality Payment Program set to launch on Jan. 1, 2017, the American Medical Group Association (AMGA) provided CMS with several MACRA implementation suggestions, including transition year elimination by 2018 and Medicare Shared Savings...

CMS Reveals Medicare-Medicaid Accountable Care Organization

by

CMS recently unveiled a Medicare-Medicaid accountable care organization (ACO) model that will allow participating providers in the Medicare Shared Savings Program to take on accountability for Medicaid costs and quality of care for dual-eligible...

PQRS Medicare Payment Adjustments Waived After ICD-10 Update

by

Some eligible professionals and group practices will not receive Physician Quality Reporting System (PQRS) Medicare payment adjustments in 2017 and 2018 because of the recent ICD-10 update, CMS recently announced in an email. The announcement...

VA Gives RNs Full Practice Authority to Improve Care Access

by

The Department of Veterans Affairs (VA) will now give some advanced practice registered nurses full practice authority in order to boost care access and quality of care. However, certified registered nurse anesthetists will not benefit from expanded...

2018 Advanced APM Options Added to Quality Payment Program

by

Eligible clinicians now have more opportunities to earn value-based incentive payments by participating in the Advanced Alternative Payment Model track of the Quality Payment Program in 2018, according to a recent CMS announcement. Starting in...

CMS Adds 2 Compare Websites to Boost Healthcare Transparency

by

In effort to increase healthcare transparency, CMS recently added two new healthcare organization Compare websites and updated performance data for existing hospice care, hospital, and physician Compare websites. “At CMS, one of our top...

CMS Hinders Private Plan Steering for Claims Reimbursement Bump

by

CMS recently released an interim final rule designed to prevent providers at Medicare-certified dialysis centers from inappropriately steering patients away from Medicare and Medicaid in order to get higher claims reimbursement rates under the...

Developing Post-Acute Networks for APM Reimbursement Success

by

About 85 percent of healthcare C-suite leaders expect to expand post-acute care partnerships over the next three years, especially as their organizations aim to maximize alternative payment model reimbursement, a recent Premier report found....

Provider Orgs Seek Healthcare Costs Tools for Value-Based Care

by

Provider organizations are increasingly looking to implement healthcare costs tools to better manage healthcare supply chain costs under value-based care models, a recent Black Book Market Research survey stated. The survey of 1,158 healthcare...

How Palliative Care Can Maximize Value-Based Reimbursement

by

Providers can boost value-based reimbursement success by incorporating early palliative care into routine cancer care delivery, a new study in the American Journal of Managed Care indicated. Researchers at the Center to Advance Palliative Care...

HHS Sec. Burwell Shares Vision for Value-Based Care Future

by

In a recent Health Affairs blog post, HHS Secretary Sylvia Mathews Burwell called for value-based care progress after the Obama administration ends through more alternative payment models, care delivery transformation, and health data access....

GAO Finds Value-Based Care Issues for Small, Rural Practices

by

A recent Government Accountability Office (GAO) report found that small and rural practices faced several challenges with implementing value-based care models, such as limited financial resources, a lack of interoperable health IT, population...

Value-Based Care, Hospital Revenue Cycle Lead Top 2016 Stories

by

From the final MACRA implementation rule to new value-based care initiatives, 2016 certainly did not leave healthcare providers bored at their desks. Instead, providers were busy digesting changes to reimbursement structures and researching ways...

61% of ACO Contracts Only Include Upside Financial Risk

by

A recent Leavitt Partners study showed that 61 percent of accountable care organization (ACO) contracts are upside risk-only, indicating that ACOs may be risk-adverse or are still in the experimental stage with financial risk. Even though ACOs...

OR Cost Scorecards Help Reduce Healthcare Supply Chain Costs

by

Healthcare supply chain costs dropped by 6.54 percent per case in surgical departments that provided surgeons with monthly cost scorecards and had a financial incentive to reduce surgical supply chain spending, a new study in JAMA Surgery found....

AMGA: Value-Based Reimbursement Transition Slower Than Expected

by

Fee-for-service revenue decreased by more than 20 percent as value-based reimbursement payments increased, reported the American Medical Group Association (AMGA). But the transition to value-based reimbursement may be slowing down compared to...

Judge Calls for Medicare Appeals Backlog Elimination by 2020

by

The Department of Health and Human Services (HHS) must eliminate the Medicare appeals backlog at the administrative law judge review level by Dec. 31, 2020, a federal judge recently decided. The most recent decision ends a two-and-a-half-year...

AHA, FAH: ACA Repeal Could Cost Hospital Revenue Cycle Billions

by

Providers could face billions in hospital revenue cycle losses if the Affordable Care Act is repealed without replacement legislation that preserves health coverage increases and rolls back claims reimbursement cuts, stated the American Hospital...

X

Join 30,000 of your peers and get free access to all webcasts and exclusive content

Sign up for our free newsletter:

Our privacy policy

no, thanks