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

Revenue Cycle Management Healthcare News

Keep Medicare Bundled Payment Models Mandatory, Experts Say

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Switching Medicare bundled payment models that are currently mandatory in select regions to voluntary across the country would impede value-based reimbursement progress through episodic payment, industry experts warned the Trump administration...

28% of Adults Say Docs Discuss Patient Financial Responsibility

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Patients are still trying to figure out and compare healthcare prices, a recent Public Agenda survey showed. Yet only about 28 percent of the over 2,000 adults Americans surveyed said that their provider or their staff have discussed patient...

AHA: Uncompensated Care Costs Worksheet Inaccurate, Inconsistent

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The American Hospital Association (AHA) recently called on CMS to audit and modify the hospital cost report, Worksheet S-10, before the federal agency uses the report to determine each hospital’s uncompensated care costs and supplemental...

Hospital Execs Focus on Outpatient Growth, Healthcare Costs

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At the top of hospital and health system priority lists for 2017 is expanding patient access to ambulatory or outpatient care settings, according to 183 C-suite executives recently surveyed by the Advisory Board. Ranking at number six in last...

Medicaid Expansion Linked to $5M Annual Hospital Revenue Boost

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Hospital revenue in Medicaid expansion states increased by $5 million annually per facility after states chose to extend Medicaid coverage to more individuals, a recent Robert Wood Johnson Foundation and Urban Institute report showed. The study...

Healthcare Mergers May Face New Federal Rules Under SMARTER Act

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In a 16 to 20 vote earlier this week, the House Judiciary Committee passed the Standard Merger and Acquisition Reviews Through Equal Rules Act (SMARTER Act), which could affect how federal antitrust agencies evaluate healthcare mergers and acquisitions....

32 Orgs to Cut Healthcare Costs, Use Under CMS Community Demo

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As part of the Accountable Health Communities Model, CMS recently selected 32 organizations to participate in two of the three program tracks that aim to lower healthcare costs and utilization by fostering clinical and community service provider...

Healthcare Consumerism Challenges Primary Care Business Models

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Primary care providers are facing significant and oftentimes conflicting challenges in response to two major healthcare trends: value-based purchasing implementation and the rise of healthcare consumerism, a recent Journal of Internal Medicine...

Physician Compensation for Specialists 45.6% More than for PCPs

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According to a recent Medscape survey, physician compensation for specialists was 45.6 percent more than what primary care providers earned in the past year. The survey of over 19,200 physicians in 27 specialists uncovered that the average physician...

Healthcare Costs Rise With Regional Post-Acute Care Variations

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Despite receiving similar post-acute care services overall, rural hospital patients tend to undergo more skilled nursing facility treatment than home health care versus urban hospital patients, contributing to higher healthcare costs, according...

CMS Pauses Home Health Pre-Claim Review Demonstration

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CMS recently halted the home health Pre-Claim Review demonstration in Illinois for 30 days and the program will not expand to Florida as expected in April 2017, according to the federal agency’s website. “After March 31, 2017, and...

AMGA Supports 15% Limit for Medicare Advantage Encounter Data

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AMGA recently applauded CMS for further reducing the percentage of encounter data to be used to determine Medicare Advantage enrollee risk scores from 25 percent in the proposed rule to 15 percent in the final 2018 performance year update. “It...

MIPS Reporting Success Depends on Choosing Suitable Measures

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For Merit-Based Incentive Payment System (MIPS) reporting success, eligible clinicians should report on quality measures that they know their practice already performs well on, advised Michael Abrams, MA, a managing partner at the healthcare...

AHA: Post-Acute Care Medicare Reimbursement Reform Needs Time

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Later this month, the Medicare Payment Advisory Commission (MedPAC) plans to vote on a draft recommendation to Congress that would accelerate the development and implementation of a unified Medicare reimbursement system for four post-acute care...

Lean Primary Care Improves Physician Productivity, Costs

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A recent American Journal of Managed Care study showed that implementing a Lean primary care model resulted in operational cost reductions, physician productivity improvements, and higher patient satisfaction scores. “Our findings indicate...

Is Radiation Overuse Contributing to Higher Healthcare Costs?

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Oncologists could have saved over $164 million in healthcare costs if they had adhered to clinical guidelines and prescribed shorter radiation treatment for some breast cancer patients, a recent Journal of Oncology Practice study revealed. Only...

Patient Collection Rates Drop as Out-of-Pocket Costs Go Up

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Hospitals collect significantly less from patients with higher out-of-pocket costs, a Crowe Horwath study confirmed. The study revealed that collection rates for patient accounts with balances greater than $5,000 were four times lower than collection...

Bundled Payment Models Here to Stay Despite CMS Program Delays

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CMS may have issued three-month delays for several new healthcare bundled payment models, but providers should still anticipate the shift to value-based purchasing through the episodic alternative payment model, said Colin Luke, a partner at...

Nurse Practitioner, Physician Assistant Salary Grew in 2016

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As nurse practitioner and physician assistant salary rates continue to rise, a recent PracticeMatch survey found that more advanced practitioners are also increasingly enjoying their jobs. The survey of over 1,000 nurse practitioners and physician...

Oncologist Org Opposes MedPAC Medicare Reimbursement Changes

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The Community Oncology Alliance (COA) recently expressed concerns that proposed Medicare reimbursement changes for Part B services from the Medicare Payment Advisory Commission (MedPAC) would drive cancer care to more higher-cost settings. “MedPAC...

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