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

Revenue Cycle Management Healthcare News

Healthcare RCM, Patient Collections Solutions Launch at HIMSS17

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ORLANDO - With over 40,000 healthcare stakeholders milling around Orlando’s Orange County Convention Center for HIMSS17, big and small vendors were eager to show off the latest and greatest products in healthcare revenue cycle management....

Payer, Provider Dialogue Key to Prior Authorization Reform

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ORLANDO - Prior authorization reform has recently been a hot topic for many healthcare industry groups and it was no different at HIMSS17. To find out more about what providers and payers plan on doing to alleviate the administrative and care...

Creating a Population Health Management Operating Model

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ORLANDO - “Collaboration is a critical piece,” Steven Merahn, MD, emphasized during his HIMSS17 session on developing an operating model for population health management that functions regardless of payment model participation. “Collaboration...

CMS Awards $100M for Small, Rural Clinician MACRA Help

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ORLANDO - CMS recently selected 11 healthcare organizations to receive a total of $100 million in funding to help small and rural eligible clinicians participate in the newly-launched MACRA. Each organization received $20 million to provide hands-on...

Only 20% of Providers Offer Card-On-File Patient Collections

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Even though patient financial responsibility continues to grow, a recent Navicure survey showed that many healthcare organizations are not meeting patient collection needs, such as electronic payments. Th survey of providers and patients from...

GA Dentist Sentenced to Prison for $1M Medicaid Fraud Scheme

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A dentist from Georgia faces one and a half years in federal prison after she reportedly participated in a Medicaid fraud scheme totaling almost $1 million, the Department of Justice (DoJ) recently announced. From 2009 to 2013, Oluwatoyin Solarin,...

Healthcare C-Suite, Earned Incentive Compensation Down in 2016

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Median healthcare CEO compensation in terms of total cash value remained relatively the same for non-physician executives in 2016, while physician CEOs faced a 3.9 percent reduction, a recent AMGA Consulting survey found. The survey of 78 medical...

78% of Hospital Staff Still Face Manual Supply Chain Management

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Hospitals may not be operating with the most efficient healthcare supply chain management tools, a recent Cardinal Health and SERMO survey found. Only 17 percent of hospital staff reported that their facility installed an automated inventory...

Coalition Offers CMMI, Alternative Payment Model Improvements

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Thirty-five healthcare industry groups recently banded together to offer the newly-approved Department of Health and Human Services (HHS) Secretary a set of guidelines for CMS Innovation Center (CMMI) and alternative payment model development...

FFS, Risk-Based Medicaid ACO Programs Similarly Reduce Costs

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In a comparison of two state Medicaid Accountable Care Organization (ACO) programs, researchers in a JAMA Internal Medicine study found that Oregon’s global capitation ACO model produced similar healthcare savings and care quality improvements...

MGMA to Price: Simplify MACRA, Reassess Alternative Payment Models

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MGMA would like HHS Secretary Tom Price to reduce the regulatory burdens of HIPAA and MACRA, reassess the development of Alternative Payment Models (APMs), and postpone implementation of the ONC’s 2015 Certified EHR criteria, the organization...

One-Third of Healthcare Execs Ready for MACRA Implementation

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Only 35 percent of healthcare executives said that their organization has a MACRA implementation strategy and feels prepared for the new value-based reimbursement program, according to a recent Health Catalyst and peer60 survey. The survey of...

2012 MSSP ACOs Decreased Post-Acute Care Spending by 9%

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A new JAMA Internal Medicine study showed that Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) established in 2012 decreased post-acute care spending by a 9 percent differential reduction by 2014 without compromising...

Asthma Education Model Lowers Resource Use, Healthcare Costs

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Asthma education programs can help providers to significantly reduce unnecessary resource use and healthcare costs by boosting patient knowledge about chronic disease management, a recent American Journal of Managed Care study stated. About 12...

Stakeholders Propose 4 MACRA Physician-Focused Payment Models

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MACRA’s Quality Payment Program offers 5 percent maximum incentive payments if eligible clinicians sufficiently participate in an Advanced Alternative Payment Model (APM) from 2017 to 2022. But many specialists are still waiting for CMS...

MACRA Implementation, Healthcare Consumerism Trends at HIMSS17

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As healthcare stakeholders are packing their bags for the upcoming HIMSS17 conference in sunny Florida, many are expecting to learn about the hottest healthcare revenue cycle management topics from the past year. From MACRA implementation and...

52-47 Senate Vote Confirms Tom Price as New HHS Secretary

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Early this morning, the Senate approved Tom Price as the new Department of Health and Human Services (HHS) Secretary by a 52 to 47 vote, according to multiple sources. Price, a Republican representative from Georgia, will be the first provider...

HHS: Physician Self-Referral Law Hinders Value-Based Care

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Some healthcare fraud prevention regulations many impede value-based care models that use financial incentives to encourage providers to improve care quality and reduce healthcare costs, the Department of Health and Human Services (HHS) recently...

NY Clinic Manager Pleads Guilty in $70M Medicare Fraud Scheme

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A New York-based healthcare clinic manager recently pled guilty for his role in a Medicaid and Medicare fraud ring involving three clinics across New York City. The scheme to defraud federal healthcare programs resulted in $70 million in fraudulent...

AMA: Eliminate Prior Authorization for Opioid Abuse Treatment

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The American Medical Association (AMA) recently called on attorney generals across the nation to follow in New York’s footsteps with reforming prior authorization requirements for medication-assisted treatment for opioid abuse. New York’s...

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