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

Revenue Cycle Management

WEDI ICD-10 Readiness Survey Recommends HHS Compliancy

by Jacqueline DiChiara

As ICD-10’s spotlight beams brighter with nearly 50 days remaining until its formal implementation, the big question is – will October 2 be the beginning of a revenue cycle downward death spiral or merely just another uneventful Friday?...

4,000 Healthcare Providers Receive $54M for HEDIS Excellence

by Jacqueline DiChiara

Physicians are demonstrating their continued dedication to advancing the quality of healthcare and helping Medicare Advantage members receive optimum treatment and are getting paid accordingly for doing so. UnitedHealthcare recently distributed...

Is the ACA Working as Intended to Improve Healthcare Access?

by Jacqueline DiChiara

Is the Affordable Care Act (ACA) living up to its full potential or is it more a matter of all healthcare hands on deck? In past interviews with, healthcare experts and leaders from both athenahealth and the Robert...

Will Medicare Part D Prescription Drug Plans Stabilize?

by Jacqueline DiChiara

As Medicare – established along with Medicaid on July 30, 1965 – formally hits its 5-decade anniversary this week, the healthcare industry turns over a new financial leaf upon considering where new spending and saving focuses...

How Can Hospitals Refocus Cost Reduction, Payment Tactics?

by Jacqueline DiChiara

As hospitals consider various ways to strengthen their revenue cycle, they may be focusing on the wrong places while overlooking the right places. As the expansion of hospital acquisition and mergers continues with more vigor, healthcare costs...

Is Sustainability the Future of Healthcare Spending Growth?

by Jacqueline DiChiara

Healthcare spending growth is expected to increase throughout the next decade, according to newly released data from Health Affairs via the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary (OACT). Are future surmised numbers...

CMS Releases New Medicaid Enrollment, Medicare Coverage Data

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) has released updated Medicare state-by-state enrollment numbers. Over 55 million individuals are covered via Medicare, says CMS. This number is 36 million greater than nearly 50 years ago...

5 Revenue Cycle Trends for ASCs, Ambulatory Practices

by Jacqueline DiChiara

Ambulatory practices and ambulatory surgical centers (ASCs) – outpatient healthcare facilities providing same-day surgical care as an alternative to a hospital stay – have specific revenue cycle needs that require unique attention...

‘Unjustified’ Premium Increases Obstruct ACA’s Transparency

by Jacqueline DiChiara

Covered California – which encompasses almost 13 percent of all Marketplace enrollees paying for nationwide coverage – announced yesterday a “modest” anticipated 4 percent statewide weighted average increase for 2016 healthcare...

Women’s Health Leader Shuns Senate’s Blocked ACA Repeal Vote

by Jacqueline DiChiara

The Affordable Care Act (ACA) is the most monumental breakthrough for women’s health within the last quarter century, according to a press release from Debra L. Ness, President of the National Partnership for Women & Families (NPWF)....

How to Maximize Revenue Capture with Low Costs, High Quality

by Jacqueline DiChiara

Charge capture is one of many moving parts within the greater healthcare reform machine. It is a vital piece that encompasses a string of financial challenges. As wrote, as healthcare consumers attain greater power...

Is CMS’s Hospital Quality Star Rating System Non-Compliant?

by Jacqueline DiChiara

The Hospital Quality Star Rating System from The Centers for Medicare and Medicaid Service (CMS) is facing scrutiny. Some industry-wide trepidation exists about whether or not CMS’s Hospital Quality Star Ratings System will result in actionable,...

$2 Billion Spent on Preventable Healthcare Costs, Says MHD Study

by Sara Heath

Preventable healthcare spending is on the rise, according to a Minnesota Health Department (MHD) analysis of state emergency department visits, hospital admissions, and hospital readmissions. The study showed that approximately 1.3 million of...

5 Needed Considerations in ICD-10 Enterprise Risk Management

by Jacqueline DiChiara

Enterprise risk management – the rather involved process of minimizing financial risk to capital and earnings through effective organization, leadership, and control – is emerging as a central ICD-10 focus. Despite hearty preparation...

CMS Trustees Report Historic Low in Medicare Cost Growth

by Sara Heath

Growth in Medicare costs remains low, according to the Trustees report released on July 21 by the Centers for Medicare & Medicaid Services (CMS). The Trustees report indicates that the Medicare trust fund will remain solvent until 2030, which...

Medicare Care Choices Model Awards Drive Choice, Quality

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) is focused on helping Medicare beneficiaries, their families, and loved ones acquire the right type of healthcare. This week, CMS announced the 141 urban and rural hospices selected...

Healthcare Providers Await Slashed Revenue Following ICD-10

by Jacqueline DiChiara

Will ICD-10 implementation on October 1 kick off as a dynamic bang or a lackluster bust? Most healthcare providers are optimistic when it comes to ICD-10 reimbursement and workflow expectations, according to results from a recently released ICD-10...

Will CMS’s Star Ratings Improve Home Health Agencies’ Quality?

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) has published the first star ratings for Home Health Agencies on As the significance of a rating system is essential to the lives of many – from considering restaurant...

Price Transparency Laws Exclude Adequate Price Information

by Jacqueline DiChiara

Pricing Transparency laws paint a “bleak picture" with “much work to be done,” according to the third annual Catalyst for Payment Reform (CPR) – Health Care Incentives Improvement Institute (HCI) Report Card...

Value-Based Purchasing Model Revises Home Health Payments

by Jacqueline DiChiara

In an ongoing effort to advance the quality of economically profitable healthcare, the Centers for Medicare & Medicaid Services (CMS) looks again to the promotion of care quality. CMS’s new proposal launch, authorized through the Affordable...


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