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

Affordable Care Act

How does the ACA Impact Providers’ Trust of Payers?

by Jacqueline DiChiara

How are those healthcare payers participating in Affordable Care Act (ACA) implementation performing? Perhaps pretty well, according to a tenth annual PayerView report card and ninth annual Payer Trust Index released consecutively by athenahealth...

King v. Burwell Requires Addressing the Affordability Crisis

by Jacqueline DiChiara

The Supreme Court will soon rule on King v. Burwell, a momentous lawsuit intended to essentially reverse various pieces of the Affordable Care Act (ACA) with the possibility of subsidies for 6.4 million Americans coming to an end. Although a...

Is King v. Burwell a ‘Downward Death Spiral’ for Revenue?

by Jacqueline DiChiara

  King v. Burwell – a critical landmark lawsuit aimed to actively unravel core components of the Affordable Care Act (ACA) – is a heavily trending topic this week as the healthcare industry awaits the Supreme Court’s...

June 19: Week That Was in Healthcare Fraud and Malpractice

by Jacqueline DiChiara

Here is a general roundup of the past week’s developments in healthcare fraud and malpractice, as reported by the Department of Justice and the Office of Inspector General. The crimes reported below result in multiple millions of dollars...

CMS’s Internal Controls Neglect Payment Accuracy under ACA

by Jacqueline DiChiara

The internal controls that calculate and authorize financial assistance payments on behalf of the Centers for Medicare & Medicaid Services (CMS) are failing, says a report from the Office of the Inspector General (OIG)....

Will Inefficient Financial Healthcare Reform Kill the ACA?

by Jacqueline DiChiara

Is the Affordable Care Act (ACA) hurling the healthcare industry further into the red? The answer is a definite yes, according to a recent RevCycleIntelligence.com article about key findings from a pair of Harvard Medical...

Senate Finance Committee, NKF Address Medicare Spending

by Jacqueline DiChiara

The vast majority of Medicare dollars – 93 percent – accounts for chronic illness. As reported by RevCycleIntelligence.com, a recent legislative proposal from the Senate Finance Committee aims to dramatically improve care for rurally-based...

Is Consumer-Centric Revenue Cycle Management the Solution?

by Jacqueline DiChiara

Is revenue cycle management in need of a drastic overhaul? As the ever evolving landscape of the healthcare industry continuously adjusts its sails, revenue cycle management may be continuously falling backwards amidst antiquated winds. A...

ACA Adds Billions in Bureaucratic Waste, Administrative Costs

by Jacqueline DiChiara

The Affordable Care Act (ACA) will prove a tremendous financial burden to the healthcare industry. Although the administrative costs of healthcare are projected to remain high throughout 2022, the ACA only promotes billions of dollars...

CMS Proposed Rule Modernizes CHIP and Medicaid Managed Care

by Jacqueline DiChiara

Following a recent series of proposed physician fee schedules and payment rules from the Centers for Medicare & Medicaid Services (CMS), a new proposed rule, CMS-2390-P, aims to modernize Medicaid managed care policies to mirror changes within...

Do Reimbursement Limitations Deter Telemedicine Integration?

by Jacqueline DiChiara

Telemedicine and reimbursement do not always go hand in hand. Reimbursement complications often hinder telemedicine's progression within the healthcare industry, as RevCycleIntelligence.com reported. Nadia de la Houssaye,...

Spending Advances Medicaid with Transparency, Accountability

by Jacqueline DiChiara

The US Government Accountability Office (GAO) has released a report reviewing approved expenditure authorities within section 1115 of the Social Security Act. This segment of the Social Security Act allows the Secretary of the Department...

EHRs Advance Medicaid Reimbursement and Stabilize Insurance

by Jacqueline DiChiara

The meaty 1,024 pages of the Affordable Care Act (ACA) call for the vast expansion of healthcare coverage, the active promotion of decreased healthcare costs, and enhanced quality care. In the midst of ACA expansion efforts, Medicare and Medicaid...

Independent Payment Advisory Board Threatens Medicare Costs

by Jacqueline DiChiara

There are new Medicare cost concerns within the healthcare industry. Hundreds of healthcare organizations are actively voicing concerns to Congress about financial threats to private sector consumers and a possible watering down of industry-wide...

$101M ACA Health Center Funding Increases Healthcare Access

by Jacqueline DiChiara

$101 million in Affordable Care Act funding will go toward the delivery of comprehensive primary health services at 164 new health center sites across 33 states. The objective of such funding – the New Access Point Grant Awards –...

Cost Inflation of Hospital Mergers, Physician Acquisitions

by Jacqueline DiChiara

In a recent letter addressed to The Wall Street Journal’s Editor from a group of healthcare leaders and experts, Rich Umbdenstock, President and CEO of the American Hospital Association (AHA), Brian Kent, MD, Robert W. Geist, MD, and Richard...

Skilled Nursing Facility Payments Projected to Rise by $500M

by Jacqueline DiChiara

New policy changes further promote the Medicare payment transition from volume to value within the healthcare industry. The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule totaling 150 pages, CMS-1622-P, in mid-April regarding...

Bundled Hospital Care Payments: Remodeling a Broken System

by Jacqueline DiChiara

The concept of bundled hospital care payments — a singular (bundled) payment generated from hospitals, physicians, and post-acute care providers for services rendered from a specific care episode — has been under close microscopic...

Will Hospital Ratings Promote Transparency or Blind Eyes?

by Jacqueline DiChiara

Choosing a hospital based on quality of care in relation to financial factors can be an arduous task. The Centers for Medicare & Medicaid Services (CMS) is simplifying this process through its new introduction of hospital star ratings announced...

Mechanized Claims Processing the Future of Medicaid?

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) present a proposed rule to extend enhanced federal financial participation for Medicaid eligibility and enrollment systems beyond the...

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