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

Healthcare Revenue Cycle

Benefits, Challenges of Value-Based Health IT Implementation

by Jacqueline Belliveau

From EHR systems to mHealth apps, health IT has the potential to help providers achieve value-based care goals. But with hundreds of new technologies seemingly emerging each day, many providers are struggling to select the most appropriate health...

How Broader Primary Care Teams Can Decrease Healthcare Costs

by Jacqueline Belliveau

Developing broader primary care teams that interact with specific patient populations can save healthcare costs and realize a return on investment, according to a recent PricewaterhouseCoopers (PwC) analysis. For example, a primary care team...

CMS: Rural Healthcare Faces Hospital Revenue Cycle Challenges

by Jacqueline Belliveau

In a statement at the CMS Rural Health Summit yesterday, CMS Acting Administrator Andy Slavitt identified rural communities as one of the biggest opportunities for healthcare reform because rural areas face more hospital revenue cycle challenges,...

How MACRA Implementation Rules Affect Provider Profitability

by Jacqueline Belliveau

New value-based reimbursement models under the Quality Payment Program will launch on Jan. 1, 2017, leaving a couple of months for providers to educate themselves on MACRA implementation rules and prepare their practices for the shift. But taking...

3M, Verily to Create Healthcare Revenue Cycle, Pop Health Tool

by Jacqueline Belliveau

3M Health Information Systems recently partnered with Verily Life Sciences to develop a technological platform that providers and payers can use to analyze population health measurements to better assess clinical and healthcare revenue cycle...

Black Book Names Optum360 Top HIM, Coding Outsourcing Vendor

by Jacqueline Belliveau

Optum360 earned the top spot for health information management (HIM) and computer-assisted coding outsourcing vendor among hospital chains, systems, corporations, and integrated delivery networks as well as independent inpatient facilities, according...

How Value-Based Reimbursement Affects Physician Productivity

by Jacqueline Belliveau

As payers push for more value-based reimbursement adoption, many healthcare organizations are wondering how to restructure physician productivity strategies to meet the unique requirements of performance-based payments. But the key to success...

Appeals Court Supports FTC Request to Stop PA Hospital Merger

by Jacqueline Belliveau

A federal appeals court recently reversed a lower court’s decision to deny the Federal Trade Commission’s (FTC) request to temporarily pause the hospital merger between Penn State Hersey Medical Center and PinnacleHealth System until...

Cerner Earns Top Revenue Cycle Management Outsourcing Vendor

by Jacqueline Belliveau

Black Book Market researchers ranked Cerner Business Office Services as the top rated end-to-end physician revenue cycle management outsourcing vendor. Cerner earned high marks on eighteen key performance indicators relating to client experience...

Health Systems, Physicians See Significant Revenue Losses in 2015

by Jacqueline Belliveau

Both integrated healthcare systems and private physician practices saw operating losses in 2015, according to a revenue cycle management survey conducted by the American Medical Group Association. Integrated healthcare systems saw an operating...

85% of Orgs Looking to Replace Revenue Cycle Management Systems

by Jacqueline Belliveau

Eighty-five percent of provider organizations, hospitals, and physician practices are currently seeking to replace their healthcare revenue cycle management systems or are deciding if it is time to switch, according to a new survey from Black...

Court Denies HHS Wish to Delay Medicare Appeals Backlog Case

by Jacqueline Belliveau

A federal district court recently denied a request from the Department of Health and Human Services (HHS) to postpone proceedings on a Medicare appeals backlog case until Sept. 30, 2017, according to the court’s decision. US District Judge...

Children’s Hospitals Vulnerable to Uncompensated Care Cuts

by Jacqueline Belliveau

Pediatric healthcare providers, especially those practicing in free-standing children’s hospitals, could face serious financial setbacks following upcoming uncompensated care payment reductions as mandated by the Affordable Care Act, a...

AHA Urges CMS to Withdraw Uncompensated Care Payment Changes

by Jacqueline Belliveau

The American Hospital Association (AHA) recently penned a letter to CMS Acting Administrator Andy Slavitt urging the federal agency to withdraw its proposed rule to include third-party payments, such as private payer and Medicare reimbursements,...

Value-Based Care Spurs Higher Physician Consolidation Rates

by Jacqueline Belliveau

More healthcare providers are moving to larger group practices in order to gain access to more resources to effectively implement value-based care and risk-based reimbursement models, according to a recent Datawatch report in Health Affairs....

WEDI Guide Suggests New Electronic Fund Transfer, ERA Standards

by Jacqueline Belliveau

The Workgroup for Electronic Data Interchange (WEDI) recently released a guide that advised all healthcare stakeholders to implement Automated Clearing House (ACH) Electronic Funds Transfers (EFT) and Electronic Remittance Advice (ERA) standards...

How a Small Hospital Developed Lean Supply Chain Management

by Jacqueline Belliveau

When hospitals start to dig into how their organizations can reduce healthcare costs without lowering care quality, many run the risk of overlooking several cost-cutting opportunities in their healthcare supply chain management process. But developing...

Reducing Use of Low-Value Services Cuts Healthcare Costs

by Jacqueline Belliveau

Providers can substantially lower their healthcare costs by reducing the use of low-value services, even though these services account for a substantially small portion of healthcare spending, according to a recent study by the RAND Corporation...

Group Calls for Off-Label Drug Claims Reimbursement Guide

by Jacqueline Belliveau

The federal government should develop a single resource that clarifies what off-label drug uses would qualify for federally-funded claims reimbursement, researchers stated in a recent study in the Journal of the American Medical Association....

CMS Must Inform Providers on New Medicare Reimbursement Policy

by Jacqueline Belliveau

A Vermont judge has ordered CMS to further educate providers and auditors about a recent Medicare reimbursement policy that affects skilled nursing and rehabilitation facilities, reported the Center for Medicare Advocacy. The court stated that...

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