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

Practice Management News

MACRA Implementation, Healthcare Consumerism Trends at HIMSS17

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As healthcare stakeholders are packing their bags for the upcoming HIMSS17 conference in sunny Florida, many are expecting to learn about the hottest healthcare revenue cycle management topics from the past year. From MACRA implementation and...

NY Clinic Manager Pleads Guilty in $70M Medicare Fraud Scheme

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A New York-based healthcare clinic manager recently pled guilty for his role in a Medicaid and Medicare fraud ring involving three clinics across New York City. The scheme to defraud federal healthcare programs resulted in $70 million in fraudulent...

Did Risk-Based APMs Propel Greater Provider Consolidation?

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A recent Health Affairs study revealed that risk-based alternative payment models, such as accountable care organizations (ACOs), have not spurred greater provider consolidation in the post-Affordable Care Act healthcare environment. Medicare...

Hospital Costs Fall Despite Overall Healthcare Spending Growth

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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...

Former Tenet Exec Charged in $400M Healthcare Fraud Scheme

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The Department of Justice (DoJ) recently announced the indictment of Tenet Healthcare Corporation’s former senior vice president of operations for his alleged participation in a healthcare fraud scheme totaling over $400 million in inappropriate...

4 Key Ways to Boost Point-of-Service Patient Collections

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In a time of healthcare consumerism and high-deductible health plans, the patient has become a major revenue source for healthcare organizations. But without strong point-of-service patient collection strategies, providers could be seeing their...

Group Purchasing Reduces Healthcare Supply Chain Costs Up to 15%

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In the first Annual Value Report, the Healthcare Supply Chain Association (HSCA) found that group purchasing organizations reduced healthcare supply chain costs by 10 to 15 percent for providers. Prescription drug spending also went down by up...

Beth Israel, Lahey Health Move Forward with Healthcare Merger

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Massachusetts-based Beth Israel Deaconess Medical Center and Lahey Health announced plans to pursue a healthcare merger earlier this week. The two healthcare systems have debated a potential merger since 2011, but the recent letter of intent...

More Orgs Transitioning to Full Physician-Hospital Integration

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The proportion of healthcare organizations that have full physician-hospital integration with physicians on salary grew from 44 percent in 2008 to 55 percent in 2013, a new Rice University’s Baker Institute for Public Policy report found....

Predictive Analytics Top Healthcare Supply Chain Priorities

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Provider organizations ranked predictive analytics as the biggest healthcare supply chain opportunity in 2017, a recent Global Healthcare Exchange, LLC (GHX) survey revealed. The survey of 50 healthcare organizations with the most automated healthcare...

How Do Hospital Mergers Lower Costs, Drive Quality Improvement?

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Recent hospital mergers and acquisitions led to significant healthcare costs savings without sacrificing care quality and affordable prices, a recent Charles River Associates and American Hospital Association (AHA) report indicated. Based on...

Healthcare Groups Offer 21 Prior Authorization Improvements

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A coalition of 17 healthcare industry groups recently called on health plans, benefit managers, and other healthcare stakeholders to change prior authorization requirements to improve care continuity, reduce provider burdens, and improve timely...

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

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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...

CMS Brings Integrated, Multi-Payer Claims Data Access to CPC+

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In an official blog post, CMS recently touted its success with improving primary care provider productivity by giving practices in the Comprehensive Primary Care (CPC) program more multi-payer claims data access. The Medicare primary care program...

Electronic Claims Management Adoption to Save Providers $7.9B

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Healthcare providers could save about $7.9 billion annually by switching to automated claims management processes, particularly for prior authorizations, remittance advices, and claim attachment submissions, according to the 2016 CAQH Index....

Medicare Spending on Drug Coverage Tripled from 2010 to 2015

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Medicare spending on prescription drugs under the Part D catastrophic coverage program more than tripled from 2010 to 2015, increasing from $10.8 billion to $33.2 billion, the Office of the Inspector General (OIG) recently reported. The significant...

3 Most Common Healthcare Supply Chain Management Challenges

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From gauze and paper gowns to implantable medical devices and prescription drugs, provider organizations must implement efficient healthcare supply chain management processes to cut overall costs and standardize care delivery. But for many organizations,...

Flexibility Key to Revenue Cycle Management Vendor Selection

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With thousands of healthcare revenue cycle management and business intelligence analytics vendors in the market, how does a provider organization decide on just one? According to Robert Creaven, CMPE, MPA, Executive Vice President of Operations...

Market Power, Not Quality Linked to Higher Healthcare Costs

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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...

Unexpected Patient Financial Responsibility in 20% of ED Cases

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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...

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