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

Healthcare Revenue Cycle

Payer, Provider Dialogue Key to Prior Authorization Reform

by Jacqueline Belliveau

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

by Jacqueline Belliveau

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...

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

by Jacqueline Belliveau

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...

78% of Hospital Staff Still Face Manual Supply Chain Management

by Jacqueline Belliveau

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...

MACRA Implementation, Healthcare Consumerism Trends at HIMSS17

by Jacqueline Belliveau

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...

4 Key Ways to Boost Point-of-Service Patient Collections

by Jacqueline Belliveau

In a time of healthcare consumerism and high-deductible health plans, the patient has become a major revenue source for healthcare organizations. But without strong point-of-service patient collection strategies, providers could be seeing their...

Group Purchasing Reduces Healthcare Supply Chain Costs Up to 15%

by Jacqueline Belliveau

In the first Annual Value Report, the Healthcare Supply Chain Association (HSCA) found that group purchasing organizations reduced healthcare supply chain costs by 10 to 15 percent for providers. Prescription drug spending also went down by up...

Beth Israel, Lahey Health Move Forward with Healthcare Merger

by Jacqueline Belliveau

Massachusetts-based Beth Israel Deaconess Medical Center and Lahey Health announced plans to pursue a healthcare merger earlier this week. The two healthcare systems have debated a potential merger since 2011, but the recent letter of intent...

Healthcare Groups Offer 21 Prior Authorization Improvements

by Jacqueline Belliveau

A coalition of 17 healthcare industry groups recently called on health plans, benefit managers, and other healthcare stakeholders to change prior authorization requirements to improve care continuity, reduce provider burdens, and improve timely...

Executive Order Calls for ACA Financial, Marketplace Flexibility

by Jacqueline Belliveau

Just hours after taking office, President Trump signed a broad executive order that intends to minimize the “economic burden of the Patient Protection and Affordable Care Act” before an official repeal of the law. Under the executive...

HRSA Adds $5K Fines for 340B Prescription Drug Rate Overcharging

by Jacqueline Belliveau

Drug manufacturers participating in the 340B Drug Pricing Program who intentionally charge hospitals prescription drug rates higher than established ceiling prices will face a $5,000 penalty per instance, a new Health Resources and Services Administration...

3 Most Common Healthcare Supply Chain Management Challenges

by Jacqueline Belliveau

From gauze and paper gowns to implantable medical devices and prescription drugs, provider organizations must implement efficient healthcare supply chain management processes to cut overall costs and standardize care delivery. But for many organizations,...

Flexibility Key to Revenue Cycle Management Vendor Selection

by Jacqueline Belliveau

With thousands of healthcare revenue cycle management and business intelligence analytics vendors in the market, how does a provider organization decide on just one? According to Robert Creaven, CMPE, MPA, Executive Vice President of Operations...

VA Gives RNs Full Practice Authority to Improve Care Access

by Jacqueline Belliveau

The Department of Veterans Affairs (VA) will now give some advanced practice registered nurses full practice authority in order to boost care access and quality of care. However, certified registered nurse anesthetists will not benefit from expanded...

CMS Hinders Private Plan Steering for Claims Reimbursement Bump

by Jacqueline Belliveau

CMS recently released an interim final rule designed to prevent providers at Medicare-certified dialysis centers from inappropriately steering patients away from Medicare and Medicaid in order to get higher claims reimbursement rates under the...

Developing Post-Acute Networks for APM Reimbursement Success

by Jacqueline Belliveau

About 85 percent of healthcare C-suite leaders expect to expand post-acute care partnerships over the next three years, especially as their organizations aim to maximize alternative payment model reimbursement, a recent Premier report found....

AMGA: Value-Based Reimbursement Transition Slower Than Expected

by Jacqueline Belliveau

Fee-for-service revenue decreased by more than 20 percent as value-based reimbursement payments increased, reported the American Medical Group Association (AMGA). But the transition to value-based reimbursement may be slowing down compared to...

Providers Skip Healthcare Costs Talk with 68% of Cancer Patients

by Jacqueline Belliveau

As providers face increased patient financial responsibility, healthcare costs discussions with patients are becoming more important for obtaining full payment. But a new study from the Cancer Support Community showed that many providers are...

Staffing Shortages, Healthcare Reform Top C-Suite Concerns

by Jacqueline Belliveau

Healthcare C-suite executives identified staffing shortages and healthcare reform as having the largest impact of their organization’s ability to delivery care, a recent Premier survey found. About 41 percent of the 52 C-suite level respondents...

Price, Utilization Increases Upped Healthcare Spending by 4.5%

by Jacqueline Belliveau

Healthcare spending for privately insured individuals increased by 4.6 percent because of rising prices for outpatient, inpatient, and professional care services as well as prescription drugs, the Health Care Cost Institute (HCCI) recently reported....

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