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

Revenue Cycle Management Healthcare News

IL Supreme Court Maintains Non-Profit Hospital Tax Exemption

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The Illinois Supreme Court recently legally voided an appellate court’s decision that non-profit hospital tax exemption was unconstitutional. In Illinois, non-profit hospitals qualify for property tax exemption if the value of all charitable...

AMGA President, CEO Donald W. Fisher, PhD, Passes at 71

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AMGA President and CEO, Donald W. Fisher, PhD, CAE, passed earlier this week after battling cancer, the healthcare industry group reported. Fisher, who was 71 years old, had led the organization since 1980. “Don leaves a professional and...

OIG Releases Healthcare Fraud Compliance Program Guidelines

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The Office of the Inspector General (OIG) recently published guidelines on how healthcare organizations can measure the effectiveness of their healthcare fraud compliance programs. The resource guide explains how healthcare organizations of all...

NJ Quality Improvement Model Lowers Healthcare Costs by $641M

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Hospitals in New Jersey reduced healthcare costs by over $641 million between 2012 and 2016 after implementing a statewide quality improvement initiative, the New Jersey Hospital Association (NJHA) recently reported. Under the Affordable Care...

Out-of-Pocket Healthcare Spending Rose 65% at Freestanding EDs

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Freestanding emergency departments are becoming a popular alternative care setting for common conditions, such as upper respiratory infections. But a recent study in the Annals of Emergency Medicine found that median prices for out-of-pocketing...

64% of Healthcare Providers Not Ready for MACRA Implementation

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Even though MACRA’s Quality Payment Program started on Jan. 1, approximately 64 percent of healthcare providers stated that they were either unprepared or very unprepared for MACRA implementation in a February 2017 survey by Stoltenberg...

How to Prepare for Alternative Payment Model Implementation

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Implementing interoperable health IT infrastructure and a staffing model that aligns with value-based care requirements are key to successfully participating in an alternative payment model, Marjie Harbrecht, MD, a Medical Group Management...

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...

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