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

Hospital Revenue Cycle

How to Prepare for Alternative Payment Model Implementation

March 23, 2017 - Implementing interoperable health IT infrastructure and a staffing model that aligns with value-based care requirements are key to successfully participating in an alternative payment model, Marjie Harbrecht, a Medical Group Management Association (MGMA) consultant, recently told RevCycleIntelligence.com. “We have to start sharing information in a much better way and coordinating...


More Articles

How to Prepare for Alternative Payment Model Implementation

by Jacqueline Belliveau

Implementing interoperable health IT infrastructure and a staffing model that aligns with value-based care requirements are key to successfully participating in an alternative payment model, Marjie Harbrecht, a Medical Group Management Association...

Tracking Key Hospital Revenue Cycle Metrics to Up Profitability

by Jacqueline Belliveau

As the value-based reimbursement transition rolls on, many hospitals have adopted “If you can measure it, you can manage it” as their new motto. But how can providers and executives measure hospital revenue cycle management? Hospital...

Hospitals Seek Independent Docs for Referrals, Healthcare Revenue

by Jacqueline Belliveau

A recent SCI Solutions survey found that 58 percent of independent providers do not have one or more preferred referral hospital partners, suggesting a major healthcare revenue opportunity for health systems and hospitals. Out of the 549 independent...

AHA, FAH Oppose Proposed Physician Self-Referral Law Changes

by Jacqueline Belliveau

The American Hospital Association (AHA) and the Federation of American Hospitals (FAH) recently urged lawmakers to oppose a proposed bill that would extend physician self-referral allowances to physician-owned hospitals. In late February, House...

Higher Hospital Costs Stem from ICU Overuse for Some Conditions

by Jacqueline Belliveau

Healthcare providers may be able to decrease hospital costs by avoiding ICU admissions for some patients with chronic obstructive pulmonary disease (COPD), exacerbation of heart failure (HF), and acute myocardial infarction (AMI), a recent American...

Healthcare C-Suite, Earned Incentive Compensation Down in 2016

by Jacqueline Belliveau

Median healthcare CEO compensation in terms of total cash value remained relatively the same for non-physician executives in 2016, while physician CEOs faced a 3.9 percent reduction, a recent AMGA Consulting survey found. The survey of 78 medical...

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...

Hospital Costs Fall Despite Overall Healthcare Spending Growth

by Jacqueline Belliveau

Medicare spending growth on both inpatient and outpatient services hit an all-time low for the first time in 17 years, with inpatient hospital costs notably decreasing by 1.9 percent since 2015, the American Hospital Association (AHA) recently...

Hospitals, Health Systems Eye Financial Snags in ACA Repeal

by Kyle Murphy, PhD

In identical letters to the Trump Administration and Congress, the American Hospital Association and other state and regional associations are urging members of both branches of the federal government to continue working on legislation to...

How a Rural Hospital Used Health IT, EHR to Stay Independent

by Jacqueline Belliveau

In a time of declining claims reimbursement rates and value-based care, rural hospitals are struggling more than ever to improve their healthcare revenue cycle management strategies. For many rural hospitals, the decision oftentimes comes down...

Should the Hospital Readmissions Reduction Program Add Sepsis?

by Jacqueline Belliveau

The Medicare Hospital Readmission Reduction Program currently determines value-based penalties on 30-day unplanned readmissions rates for six conditions. But the value-based reimbursement program may be missing a key condition that contributes...

CMS Clarifies Site-Neutral Medicare Reimbursement Exceptions

by Jacqueline Belliveau

With the site-neutral Medicare reimbursement policy taking effect on Jan. 1, CMS recently released guidance on what hospital departments qualify for exemption from the rule. The federal agency clarified expanded site-neutral payment exemption...

Market Power, Not Quality Linked to Higher Healthcare Costs

by Jacqueline Belliveau

Higher healthcare costs at New York hospitals are linked to increased market power and not higher quality of care, the New York State Health Foundation recently reported. More expensive hospitals tended to have increased market leverage, such...

AHA Asks CMS to Increase Site-Neutral Medicare Reimbursement

by Jacqueline Belliveau

The American Hospital Association (AHA) recently advised CMS to increase Medicare reimbursement rates to off-campus provider-based outpatient departments that will be paid under site-neutral payment rules starting on Jan. 1, 2017. The industry...

Medicaid, Medicare Reimbursement $57.8B Below Hospital Costs

by Jacqueline Belliveau

Medicaid and Medicare reimbursement in 2015 was under actual hospital costs for treating beneficiaries by $57.8 billion, the American Hospital Association (AHA) recently reported. According to data from the AHA’s Annual Survey of US Hospitals,...

Does Hospital Size Impact Value-Based Penalties in CMS Program?

by Jacqueline Belliveau

Value-based penalties in the Medicare Hospital-Acquired Condition Reduction Program are disproportionately affected by a participating hospital’s bed size and number of cases, a recent American Journal of Medical Quality study indicated....

Unexpected Patient Financial Responsibility in 20% of ED Cases

by Jacqueline Belliveau

Approximately 20 percent of hospital admissions stemming from an emergency department visit in 2014 led to unexpected patient financial responsibility in the form of surprise medical bills, a recent Health Affairs study reported. Using national...

Value-Based Care, Hospital Revenue Cycle Lead Top 2016 Stories

by Jacqueline Belliveau

From the final MACRA implementation rule to new value-based care initiatives, 2016 certainly did not leave healthcare providers bored at their desks. Instead, providers were busy digesting changes to reimbursement structures and researching ways...

AHA, FAH: ACA Repeal Could Cost Hospital Revenue Cycle Billions

by Jacqueline Belliveau

Providers could face billions in hospital revenue cycle losses if the Affordable Care Act is repealed without replacement legislation that preserves health coverage increases and rolls back claims reimbursement cuts, stated the American Hospital...

Do Medicaid Reimbursement, Admissions Produce Hospital Profit?

by Jacqueline Belliveau

Do Medicaid reimbursement rates and federal uncompensated care payments really cover the healthcare costs of treating larger proportions of Medicaid beneficiaries and uninsured individuals? Two new studies in Health Affairs indicate yes, but...

Continue to site...