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

Healthcare Spending

$100B Aftermath of Medicare Access, CHIP Reauthorization Act

by Jacqueline DiChiara

The ongoing push for value-based reimbursement endures with the finalization of new legislative decisions regarding the permanent SGR repeal's ripple effect on the healthcare industry at large. The Medicare Access and CHIP...

Costly Impact of CMS’ Mental Health Parity Rule on Medicaid

by Jacqueline DiChiara

Expensive treatment for a mental health or substance use disorder often means imposed limitations in insurance coverage. Medicaid programs may soon carry the burden of alleviating such costs. The Centers for Medicare & Medicaid Services (CMS)...

Does ACA Boost Physicians’ Medicaid Participation?

by Jacqueline DiChiara

Medicaid beneficiaries are keeping the doctor away. Newly released data may offer a fresh industry-wide perspective about how often physicians accept Medicaid regarding delayed implementation stemming from the Affordable Care Act’s (ACA’s)...

Medicaid Providers Struggling to Raise Reimbursement Rates

by Jacqueline DiChiara

Medicaid providers seeking to raise their reimbursement rates by suing the government are essentially out of luck, according to documentation within a recent Supreme Court ruling. “The notion that respondents have a right to sue,”...

Has the Affordable Care Act Led to a Slowdown in Premiums?

by Jacqueline DiChiara

Slow and steady appears to be the financial mantra echoing forth within the healthcare industry. There has been a distinct deceleration in premium growth within the past three years following the implementation of Affordable Care Act...

CMS Announces Possible Delay as Medicare Doc Payment Begins

by Jacqueline DiChiara

The Bipartisan Permanent Sustainable Growth Rate (SGR) Fix and Children’s Health Insurance Program (CHIP) Reauthorization Package replaces the flawed Medicare formula as a “doc-fix.” This legislation aims to transition...

Why Is Medicaid Expansion a Win for Healthcare Providers?

by Jacqueline DiChiara

As anyone standing before a plate of freshly baked desserts or fearfully opening a credit card bill post online shopping binge can attest, the art of equilibrium is essential. This idea of balance is also needed within the financial realm of...

What is the Future of Revenue Cycle Management?

by Jacqueline DiChiara

A crystal ball showing the future of revenue cycle management depicts a spotlight brightly shining down upon an individual wearing three different hats – those of the healthcare consumer, patient, and payer. This increased focus will continue...

HHS Launches Health Care Payment Learning and Action Network

by Jacqueline DiChiara

The Department of Health and Human Services (HHS) Secretary Sylvia M. Burwell met with President Obama to launch the Health Care Payment Learning and Action Network. An estimated 2800 payers, providers, employers, patients, states, consumer groups,...

OIG Testimonies Examine 340B Savings and Medicare Fraud

by Jacqueline DiChiara

The Office of the Inspector General (OIG) recently posted written testimonial on 340B savings and Medicare fraud, as submitted to the House of Representatives from Ann Maxwell, Assistant Inspector General of the OIG Office of Evaluation and Inspections,...

Electronic Transactions Could Save Healthcare Billions  

by Jacqueline DiChiara

As the healthcare industry continuously eliminates paper-based administrative processes and pushes for mainstream electronic transactions, the possible result is essentially tens of billions in savings for the healthcare industry. If six routine...

Summary of Health Insurance Marketplace Final Rule for 2016

by Jacqueline DiChiara

CMS issued a 476-page final rule to promote improving the overall Health Insurance Marketplace consumer experience by ensuring affordable and accessible coverage options. On February 20, the federal agency released the final rule, Notice of Benefit...

Hospitals Oppose Further Medicare and Medicaid Cuts

by Stephanie Reardon

The AHA and other hospital groups wrote a letter to Congress, encouraging them to avoid  Medicare and Medicaid cuts following the repeal of the SGR. The Medicare Sustainable Growth Rate (SGR) has long been a thorn in healthcare’s...

How the 2016 Budget Will Change Medicare and Medicaid

by Stephanie Reardon

2016 Budget plans will have both improvements and challenges for  Medicare and Medicaid providers. On Monday, February 2, 2015, President Barack Obama released the 2016 Federal budget. It reveals plans for saving federal money on Medicaid...

How Do Hospitals Impact the Economy?

by Stephanie Reardon

New Jersey Hospitals impact the economy within their community. If a hospital is doing well, so is the community around it; at least that appears to be the trend found by the New Jersey 2014 Economic Impact Report. The study indicates that New...

National Health Spending Reached $2.9T in 2013

by Ryan Mcaskill

The latest report shows healthcare spending has reached $2.9 trillion in 2013 at a growth rate of 3.6 percent. Healthcare is a trillion dollar a year business and the latest numbers show that in 2013, the total national health expenditures in...

Healthcare Sector Economic Indicator Briefs Show Improvement

by Ryan Mcaskill

Focusing on spending, price and labor, new briefs show how the healthcare industry is improving. Earlier this month, the Altarum Institute released its monthly series of healthcare sector economic indicator briefs. They focus on spending, price...

U.S. Healthcare Cloud Market to Reach $3.5B by 2020

by Ryan Mcaskill

Government initiatives and regulations are pushing a shift toward growing investments in cloud technology. One of the biggest expenses for hospitals and medical practices in the current landscape is healthcare technology. Evolving regulatory...

Inpatient Volume, Revenue Drops as Outpatient Care Makes Gains

by Jennifer Bresnick

Hospitals must find ways to leverage outpatient service opportunities as a reduction in inpatient volume leaves a trail of empty beds. Inpatient volumes, and the revenues from hospital admissions, are dropping rapidly as the healthcare industry...

2.3% Medical Device Tax Won’t Heavily Impact Healthcare Buyers

by Jennifer Bresnick

The controversial medical device tax will not significantly upset the market for manufacturers or healthcare organizations, a new report says. The 2.3% medical device tax rolled up into the Affordable Care Act will have some impact on prices...

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