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

Policy & Regulation News

CMS Says Information Technology Builds Healthcare Delivery


The Centers for Medicare & Medicaid Services (CMS) is beginning the New Year with a happy and healthy resolution tied to the significance of health information technology (IT). CMS declared in an official blog post last Wednesday that it...

Why the Value-Based Care Journey Begins with Assessment


How to find value in the value-based care reimbursement movement is one goal the healthcare industry will likely be striving for in 2016. As Medicare, Medicaid, and commercial health plans continue to press hospitals and physicians to implement...

2015: Year That Was in Healthcare Fraud and Malpractice


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

How a Palliative Care Focus Eases Healthcare’s Cost Burdens


As physicians across the country mull over their New Year’s resolutions this week, the overarching desire for a healthy revenue cycle will likely be a common theme. Physicians often struggled with how to keep money flowing as easily as New...

How Advanced Care Discussions Impact Provider Payment Focus


Critical end-of-life discussions between a physician, a patient, and a patient’s family or loved ones, are perhaps being glossed over more and more because of reimbursement challenges. The Centers for Medicare & Medicaid Services (CMS)...

CMS’s Quality Measurement Development Plan Supports MIPS, APM


2016 may be an especially good year for healthcare providers when it comes to matters of revenue cycle management. The Centers for Medicare & Medicaid Services (CMS) recently posted a 63-page Measure Development Plan, a strategic framework...

How CMS’s Proposed IMPACT Act Impacts Healthcare Providers


Every patient who steps foot into a hospital – from the college quarterback with a broken collarbone to the octogenarian diagnosed with numerous comorbidities – may soon require a discharge plan, according to a new proposed rule from...

10 Standout Revenue Cycle Management Quotes of 2015


Actions speak louder than words. But sometimes, the pen is indeed mightier than the sword.  Here are 10 selected quotes (presented in no particular order), exclusive to from the last year that may make you stop...

Congress Passes 2-Year Cadillac Tax Delay, Repeal Possible


Congress has passed a two-year delay of the Cadillac Tax – a 40% non-deductible tax on the cost of employer-sponsored health coverage that surpasses specific benefit thresholds, part of the Omnibus spending package. Congress passed the...

CMS Releases Fee-for-Service Data for Home Health Agencies


The Centers for Medicare & Medicaid Services (CMS) is striving once again to make the healthcare industry more  transparent, affordable, and accountable with the dissemination of free-flowing information. CMS has released...

Why HOPD Medicare Expenditures Need Equalized Payment Rates


Medicare expenditures for hospital outpatient departments (HOPD) services are apparently on the rise, especially in recent years. A new report to Congressional requesters from the United States Government Accountability Office (GAO) examines...

Pew Recommends CMS Reconsider EHR Advance Care Plan Updates


Making decisions in life is not always easy. End-of-life care decisions are no exception. The Centers for Medicare & Medicaid Services (CMS) recently proposed numerous revisions to the physician payment system under MACRA. The Pew Charitable...

Dec. 18: Week That Was in Healthcare Fraud and Malpractice


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 (OIG). The crimes reported below result in multiple millions of...

CMS Shares New Qualified Entity Program Growth Developments


It is an exciting time for healthcare, says the Centers for Medicare & Medicaid Services (CMS). Notable transparency developments are underway, wrote Niall Brennan, CMS Chief Data Officer and the Director of the Office of Enterprise...

How Business Intelligence, CDI Focus Sharpens Revenue Cycle


Celebrating success is generally much more fun than learning from failure. But the latter is sometimes more necessary. Eighty percent of nearly 300 healthcare providers surveyed last month said ICD-10 implementation was an overall success,...

Bipartisan Congressional Support for Cadillac Tax Growing


Although the Cadillac Tax is not related to fast and furious cars, it is associated with widespread limitations on workplace health insurance. The United States Senate voted 90-10 earlier this month to approve an amendment fully repealing...

ICD-10 Grace Period News Leads 2015’s Top 5 Stories


With December already halfway over and talk of holiday celebrations and New Year’s resolutions well underway, here is’s year-end top stories list. The International Classification of Diseases, 10th Revision...

ICD-10 News the Landslide Leader in 2015’s Top 10 Stories


Just as driving a car with your eyes permanently glued to the rearview mirror is not necessarily the most intelligent decision, catching a glimpse every now and then of your current whereabouts is essential. When it comes to continued revenue...

Keeping an Eye on the Affordable Care Act: 2015 in Review


The Affordable Care Act (ACA) has come a long way over the past 12 months. It is intended, as the name implies, to make health insurance more affordable and make sure more patients greater levels of overall coverage. Here is a 2015...

Why Successful Healthcare Executives Focus on Education


The Affordable Care Act (ACA) aims to increase the number of people with health insurance by expanding Medicaid coverage nationwide. Are targets being hit or merely glossed over? Medicare Part D beneficiaries make up the bulk of the Medicare...


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