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

Healthcare Spending

Medicare Spending on Drug Coverage Tripled from 2010 to 2015

January 9, 2017 - Medicare spending on prescription drugs under the Part D catastrophic coverage program more than tripled from 2010 to 2015, increasing from $10.8 billion to $33.2 billion, the Office of the Inspector General (OIG) recently reported. The significant growth in Medicare spending on prescription drugs largely stemmed from increases in high-priced medication utilization as well as prescription...


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Medicare Spending on Drug Coverage Tripled from 2010 to 2015

by Jacqueline Belliveau

Medicare spending on prescription drugs under the Part D catastrophic coverage program more than tripled from 2010 to 2015, increasing from $10.8 billion to $33.2 billion, the Office of the Inspector General (OIG) recently reported. The significant...

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...

OR Cost Scorecards Help Reduce Healthcare Supply Chain Costs

by Jacqueline Belliveau

Healthcare supply chain costs dropped by 6.54 percent per case in surgical departments that provided surgeons with monthly cost scorecards and had a financial incentive to reduce surgical supply chain spending, a new study in JAMA Surgery found....

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....

Employing More Physician Assistants Reduces Healthcare Costs

by Jacqueline Belliveau

Adding more physician assistants to hospitalist care teams can lower healthcare costs while maintaining quality of care, a new study in the Journal of Clinical Outcomes Management contended. Researchers found that a hospitalist care team that...

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...

Primary Care Initiative Continues to Reduce Medicare Spending

by Jacqueline Belliveau

The Comprehensive Primary Care Initiative (CPC) continued to improve quality of care and reduce Medicare spending in 2015 even though the initiative has yet to generate net healthcare savings, according to an official CMS blog post. In the initiative’s...

AHA Calls for Hospital Access to Prescription Drug Rate Info

by Jacqueline Belliveau

The American Hospital Association (AHA) recently urged the Health Resources and Services Administration (HRSA) to grant hospitals in the 340B Drug Pricing Program more access to prescription drug rate information. In a comment letter on a proposed...

Hospitals Saw 23% Rise in Inpatient Prescription Drug Spending

by Jacqueline Belliveau

Hospital inpatient prescription drug spending has increased by 23.4 percent from 2013 to 2015, reported a recent study from the University of Chicago’s NORC. The increases in spending have left most providers struggling to manage their...

GAO: Healthcare Spending Data from CMS Inaccessible, Unreliable

by Jacqueline Belliveau

CMS should make healthcare spending data for skilled nursing facilities more accessible to public stakeholders and ensure the expenditure information is reliable, the Government Accountability Office (GAO) advised the federal agency in a recent...

Medical Device Reps in OR Sway Healthcare Supply Chain Costs

by Jacqueline Belliveau

Medical device sales representatives may act as key resources for surgeons on the latest technological advances and how to properly use specific devices, but the close relationship may actually be driving up healthcare supply chain costs, according...

Pharma Payments Influence Prescription Drug Spending

by Jacqueline Belliveau

Payments from pharmaceutical manufacturers may be more influential on physician prescribing habits than concerns over the rise in prescription drug spending, according to a recent study in the BMJ. Researchers found that small payments from pharmaceutical...

Cardiac Care Bundled Payment Model to Generate Modest Savings

by Jacqueline Belliveau

The recently proposed Medicare bundled payment model for cardiac care will likely bring only modest shared savings or losses to participants, according to a study from Avalere Health. About 85 percent of providers that will be required to take...

Monitoring Care Delivery Key to Reducing Healthcare Costs

by Jacqueline Belliveau

Lowering actual healthcare costs that providers incur while delivering care to patients is the key to making healthcare more affordable, according to a new Chilmark Research study. While payers are reforming claims reimbursement models to reduce...

Medicare ACOs Reduce Healthcare Spending On Complex Patients

by Jacqueline Belliveau

While one of the primary goals of joining an accountable care organization (ACO) is to coordinate care in effort to reduce healthcare spending, many Medicare ACO participants have seen early benefits from the alternative payment model. According...

End-of-Life Medicare Spending 25% Higher for Younger Seniors

by Jacqueline Belliveau

For most providers, it is not surprising that Medicare spending tends to increase in the last year of a beneficiary’s life, especially since this population is more likely to experience a serious illness and multiple chronic conditions....

$2.75B in Unexpected Healthcare Spending Impacts VA Budget

by Jacqueline Belliveau

The Department of Veteran’s Affairs (VA) has encountered $2.75 billion in unanticipated healthcare spending  during the 2015 fiscal year due to an increase in community care program participation and new hepatitis C drugs, according...

Providers Spend $15.4B to Report on Healthcare Quality Measures

by Catherine Sampson

General internists, family physicians, cardiologists, and orthopedists spend more than $15.4 billion annually to report on healthcare quality measures set by payers, according to a report from Health Affairs. Annually, these four types of practices...

Providers Prioritize Quality Care, Not Lower Healthcare Costs

by Jacqueline Belliveau

By now, many healthcare providers are partaking in some form of value-based care, which aims to foster quality care while reducing healthcare costs. To achieve this, value-based care relies on care coordination to decrease unnecessary treatments...

Do Nurse Practitioners Increase Healthcare Spending Rates?

by Catherine Sampson

While the use of independent nurse practitioners (NPs) is often seen as an important way to drive down healthcare spending rates, a new report from researchers at the University of California San Francisco indicates that the positive...

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