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

Healthcare Revenue Cycle

Top 5 Ingredients of a Successful Alternative Payment Model

by Jacqueline Belliveau

Alternative payment models tie provider reimbursement to quality and cost performance. Besides their foundational function, though, each model has its own rules pertaining to financial incentive structures, quality measurements, and patient populations...

Top 4 Claims Denial Management Challenges Impacting Revenue

by Jacqueline Belliveau

For most healthcare organizations, claim denials are a normal, if not a frequent, occurrence. While very few can boast that their denial rates are close to zero, many providers face a number of challenges with implementing an effective claims...

46% of Providers Unsure About Value-Based Purchasing Impact

by Jacqueline Belliveau

Value-based purchasing is not a new term for many providers, yet 46.4 percent of healthcare providers and leaders are still unsure how the shift away from fee-for-service payments will impact their revenue cycles, a recent Physicians Practice...

Health IT, Care Navigators Most Effective at Lowering Costs

by Jacqueline Belliveau

While countless strategies are out there for making care delivery more efficient, a recent Health Affairs study revealed that interventions that use health IT and community health workers realized the greatest cost savings. Researchers examined...

NH Judge Rejects CMS FAQs Clarifying Medicaid DSH Payments

by Jacqueline Belliveau

A district court in New Hampshire recently prohibited CMS from enforcing two Frequently Asked Questions (FAQs) that clarified how private payer and Medicare reimbursements paid to hospitals for dually-eligible Medicaid patients would be used...

AMGA Backs CMS Proposal to Limit 2018 Medicare Encounter Data

by Jacqueline Belliveau

The American Medical Group Association (AMGA) recently supported a CMS proposal to delay the increased use of encounter data to determine Medicare Advantage plan risk scores and claims reimbursement amounts. In a recent proposed rule, CMS stated...

FFS Compensation Linked to More Stroke Prevention Surgeries

by Jacqueline Belliveau

A new study in JAMA Surgery found that providers with fee-for-service compensation performed more carotid stenosis interventions on symptomatic and asymptomatic patients compared to providers reimbursed by a salary. Using data from the Military...

65% of Organized Providers Paid Via Alternative Payment Models

by Jacqueline Belliveau

Nearly two-thirds of healthcare providers in some type of integrated employment model, such as integrated health networks, physical hospital organizations, accountable care organizations, and large medical groups, are primarily reimbursed through...

Exploring MIPS Advancing Care Info, Improvement Activities

by Jacqueline Belliveau

At HIMSS17, CMS leaders took the stage to ease provider concerns about the newly launched Quality Payment Program and its more popular value-based reimbursement track, the Merit-Based Incentive Payment System (MIPS). Following up on their MIPS...

Preparing Providers for the Healthcare Consumerism Shift

by Jacqueline Belliveau

With a couple of swipes and clicks, patients are driving the shift to healthcare consumerism in the palm of their hands. But many healthcare organizations are not finding it as easy to align their care delivery and patient collection strategies...

Provider Profitability Tops Healthcare Revenue Cycle Concerns

by Jacqueline Belliveau

One of the top healthcare revenue cycle concerns with 40 percent of providers is maintaining profitability while remaining independent, a recent RemitDATA survey revealed. The survey of healthcare providers, billing companies, and vendors showed...

Healthcare RCM, Patient Collections Solutions Launch at HIMSS17

by Jacqueline Belliveau

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

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...

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