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

Revenue Cycle Management Healthcare News

Employing More Physician Assistants Reduces Healthcare Costs

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Adding more physician assistants to hospitalist care teams can lower healthcare costs while maintaining quality of care, a new study in the Journal of Clinical Outcomes Management contended. Researchers found that a hospitalist care team that...

25% of Healthcare Payments Tied to Alternative Payment Models

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Only one-quarter of healthcare payments in 2016 will be connected to an alternative payment model that has population-based accountability, reported the Healthcare Payment Learning & Action Network (LAN). The survey of over 70 commercial,...

CMS Announces New Advanced Alternative Payment Model Options

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CMS recently announced new opportunities for eligible clinicians to participate in an Advanced Alternative Payment Model (APM) under the Quality Payment Program in 2017 and 2018. The Oncology Care Model’s two-sided financial risk track...

How Broader Primary Care Teams Can Decrease Healthcare Costs

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Developing broader primary care teams that interact with specific patient populations can save healthcare costs and realize a return on investment, according to a recent PricewaterhouseCoopers (PwC) analysis. For example, a primary care team...

Patients Find Medicare Reimbursement to Surgeons Too Low

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Patients may be willing to pay more out-of-pocket expenses for certain medicals services, such as knee surgeries, especially as providers face lower Medicare reimbursement rates, a recent study in Orthopedics contended. The survey of 231 patients...

AHA Offers HHS Solutions to Reduce Medicare Appeals Backlog

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The American Hospital Association (AHA) recently advised the Department of Health and Human Services (HHS) to implement three solutions that would significantly reduce the Medicare appeals backlog at the administrative law judge level. The potential...

Ensuring Success in the Transition to Value-Based Care

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Most recently, the Department of Health & Human Services issued a final rule for the Quality Payment Program as part of implementing provisions of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. The program comprising the...

Rural Hospitals Faced Less Value-Based Reimbursement Penalties

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Rural hospitals outperformed urban hospitals in several Medicare value-based reimbursement programs in 2015, receiving fewer financial penalties, according to a recent report from the Department of Health and Human Services (HHS). Researchers...

Medicare Reimbursement Covers 88% of Medical Equipment Costs

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Medicare reimbursement rates under the Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program only cover 88 percent of overall healthcare costs associated with providing home medical equipment, according...

Industry Groups React to Final MACRA Implementation Rule

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In the week that the healthcare industry has had to digest the 2,400-page final MACRA implementation rule, many industry groups have come forward to express support for the rule, especially attestation flexibilities, while others have challenged...

CMS: Rural Healthcare Faces Hospital Revenue Cycle Challenges

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In a statement at the CMS Rural Health Summit yesterday, CMS Acting Administrator Andy Slavitt identified rural communities as one of the biggest opportunities for healthcare reform because rural areas face more hospital revenue cycle challenges,...

How MACRA Implementation Rules Affect Provider Profitability

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New value-based reimbursement models under the Quality Payment Program will launch on Jan. 1, 2017, leaving a couple of months for providers to educate themselves on MACRA implementation rules and prepare their practices for the shift. But taking...

Primary Care Initiative Continues to Reduce Medicare Spending

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The Comprehensive Primary Care Initiative (CPC) continued to improve quality of care and reduce Medicare spending in 2015 even though the initiative has yet to generate net healthcare savings, according to an official CMS blog post. In the initiative’s...

GAO: Quality Measure Misalignment Impedes Provider Improvement

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Healthcare quality measures are integral to determining value-based reimbursement, but misalignment of quality measures across public and private payers has made it more difficult for providers to develop quality improvements for value-based...

Provider Engagement Key to Accountable Care Organization Success

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Accountable care organizations (ACOs) leaders may need to boost healthcare provider engagement to foster value-based care success, a recent study in the American Journal of Accountable Care indicates. In a case study at the Johns Hopkins Medicine...

Hospitals Still Facing Medicare Claims Denial Management Issues

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A recent American Hospital Association (AHA) survey indicated that hospitals are still experiencing challenges with Medicare claims denial management under the Recovery Audit Program. The survey of 676 hospitals revealed that about 60 percent...

Impact of Quality Payment Program on Medicare Reimbursement

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With the final rule on MACRA implementation finally emerging, eligible clinicians were presented with a range of Quality Payment Program participation options that would impact Medicare reimbursement payment adjustments in 2019. The Quality Payment...

CMS Finalizes MACRA Implementation, Quality Payment Program

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CMS released the long-awaited final rule on MACRA implementation earlier today, which stated that the new value-based reimbursement system will start on Jan. 1, 2017. The final MACRA implementation rule will replace the Sustainable Growth Rate...

CMS Launches Provider Engagement, Value-Based Care Initiative

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CMS recently announced a new provider engagement initiative designed to improve the clinician experience within the Medicare program, especially as value-based care models are developed under the Affordable Care Act and MACRA. As alternative...

AHA Calls for Hospital Access to Prescription Drug Rate Info

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The American Hospital Association (AHA) recently urged the Health Resources and Services Administration (HRSA) to grant hospitals in the 340B Drug Pricing Program more access to prescription drug rate information. In a comment letter on a proposed...

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