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

Medicare and Medicaid Services

Higher Premiums, Deductibles in 2016 Medicare Part D Plan

by Jacqueline DiChiara

Many Medicare beneficiaries may soon experience increased premiums and deductibles if they fail to change plans, confirms yesterday’s issue brief from the Henry J. Kaiser Family Foundation (Kaiser). Via an analysis of key 2015 marketplace...

October 9: Week That Was in Healthcare Fraud and Malpractice

by Jacqueline DiChiara

Here is a general roundup of the past week’s developments in healthcare fraud and malpractice, as reported by the Department of Justice and the Office of Inspector General. The crimes reported below result in multiple millions of dollars...

70 Healthcare Groups Pen Medicare Part B Letter to Congress

by Jacqueline DiChiara

Medicare Part B, which helps pay for the majority of outpatient services, is in the midst of heated Congressional conversation. As RevCycleIntelligence.com reported last week, according to predictions via a personal interview with the...

CMS Awards $110M in ACA Funds to Cut Avoidable Readmissions

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) has awarded $110 million to 17 national, regional, and state hospital associations and health system organizations to help slash preventable hospital readmissions. CMS’ Partnership...

CMS Streamlines Medicaid Managed Care Process Via Rate Guide

by Sara Heath

Managed care delivery systems are an integral part of the Medicaid and Children’s Health Insurance Plan (CHIP) programs, with nearly 80 percent of Medicaid and CHIP enrollees served via managed care. The high number of individuals served...

New Focuses Emerge with National Health IT Week’s Tenth Year

by Jacqueline DiChiara

Is health information technology (health IT) silently advancing the world of medicine? As the tenth anniversary of National Health Information Technology Week from October 5-9, 2015 begins this week, such a viewpoint...

October 2: Week That Was in Healthcare Fraud and Malpractice

by Jacqueline DiChiara

Here is a general roundup of the past week’s developments in healthcare fraud and malpractice, as reported by the Department of Justice and the Office of Inspector General. The crimes reported below result in multiple millions of dollars...

HHS Announces $685M Awards in Patient-Centered Clinician Aid

by Jacqueline DiChiara

The Department of Health and Human Services (HHS) is on a mission to improve the quality of healthcare, advance patients’ information accessibility, and decrease expenses across the industry. According to today’s announcement from...

Can Cost Sharing Models Improve Medicare Spending Issues?

by Sara Heath

Although Medicare is reportedly fiscally solvent until 2030, some researchers say the program contributes to healthcare industry woes at a large extent. According to Devon M. Herrick, PhD, Health Economist and Senior Fellow at the National Center...

Will Medicare Advantage Plan Enrollment See Record Highs?

by Jacqueline DiChiara

Both the stabilization of Medicare Advantage premiums and improved accessibility of top-notch care plans are on the healthcare horizon, says the Centers for Medicare and Medicaid Services (CMS) in yesterday’s announcement. Enrollment...

Medicaid Expansion May Reduce Uninsured Hospital Patients

by Sara Heath

Despite being a major provision of the Affordable Care Act (ACA), Medicaid expansion has not been implemented in all states and is still having a notable effect on the states in which it has been adopted. According to a Kaiser Family Foundation...

AHA: Hospital Quality Star Rating System Needs Improvement

by Sara Heath

In an effort to measure hospital and patient care quality, the Centers for Medicare & Medicaid Services (CMS) has introduced the Hospital Quality Star Rating System. However, according to a recent letter from the American Hospital Association...

GAO Advises CMS to Clarify RAC’s Medicare Audit Objectives

by Sara Heath

A recent study by the Government Accountability Office (GAO) has found that the Centers for Medicare & Medicaid Services (CMS) needs to be more hands-on when working with Medicare Part D recovery audit contractor (RAC) programs. CMS began...

Calif. Managed Care Organization Tax Proposal Axed

by Sara Heath

The managed care organization (MCO) tax in California has been causing quite a debate over the past year. After the Centers for Medicare & Medicaid Services (CMS) issued a letter to the state informing them that their current MCO tax model...

CMS Releases Medicaid CHIP Eligibility Enrollment Report

by Jacqueline DiChiara

The Centers for Medicare and Medicaid Services (CMS) has released new information to assist states with Medicaid and the Children’s Health Insurance Program (CHIP) enrollment. CMS concurrently released the June 2015 monthly report...

Readers Debate the Affordable Care Act’s Anticipated Impact

by Jacqueline DiChiara

Is the Affordable Care Act (ACA) a beautiful success, a gut-wrenching failure, or a complexly vague combination of both? Simply put, opinions are mixed. Some across the healthcare industry confirm various ACA successes – more uninsured...

New CMS Payment Model Aims to Advance Nursing Facility Care

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) recently announced an innovative funding opportunity to allow payment model testing within nursing care facilities. Originated to advance the Initiative to Reduce Avoidable Hospitalizations...

3 ICD-10 Changes Include Specificity, Expansion, Combination

by Jacqueline DiChiara

ICD-10 is almost here, with only 43 days remaining. Of paramount significance come October 1 when ICD-10 implementation swings into full gear is a keen and clear understanding of what will be different this time around. The following is a narrowed...

Survey Highlights Changing Primary Care Practice Environment

by Jacqueline DiChiara

Primary care providers confirm mixed opinions regarding healthcare changes to healthcare delivery and payment within the primary care practice environment, states a new survey from the Commonwealth Fund and The Kaiser Family Foundation. Although...

CMS Adds Pilot Project Participants to Reduce Medicare Costs

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) has announced over 2,100 acute care hospitals, skilled nursing facilities, physician group practices, long-term care hospitals, inpatient rehabilitation facilities, and home health agencies...

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