Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid
  • Over 50% of Orgs Lack Adequate Healthcare Cost Reduction Goals

    September 19, 2017 - An overwhelming majority of healthcare executives (96 percent) stated that cost transformation is a significant need for their hospital or health system. Yet, over one-half of organizations either do not have a healthcare cost reduction goal or have a small goal that will not transform cost structures, a recent Kaufman Hall survey showed. One-quarter of over 150 senior executives in hospitals...

  • Bringing Back House Calls to Cut Spending on High-Risk Patients

    September 14, 2017 - Before the early 1960s, the majority of healthcare visits were performed in patient homes. But as healthcare evolved, providers could no longer fit their tools in a transportable medical bag and the proportion of visits made by house calls dropped to just 0.6 percent by 1980. The reimbursement landscape also prompted more providers to settle into offices or hospitals. Under fee-for-service...

  • Does the Medicare Physician Fee Schedule Undervalue Primary Care?

    September 12, 2017 - CMS continues to put the revenue of primary care providers at risk by undervaluing codes for primary care and failing to meet the misvalued code target required by law in the proposed 2018 Medicare Physician Fee Schedule update, the American Academy of Family Physicians (AAFP) recently argued. The federal agency is charged with ensuring that relative value units (RVUs) used to determine Medicare...

  • Key Strategies for Health Systems to Achieve Economies of Scale

    August 31, 2017 - Companies from across industries use economies of scale to realize cost savings. While hospitals and health systems are borrowing the economic concept to reduce spending, many healthcare organizations have encountered challenges with achieving the benefits of economies of scale. The Healthcare Financial Management Association (HFMA) defines economies of scale as the “gains provided through...


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Reps Eye Delay for Medicaid Disproportionate Share Hospital Cuts

Three House Representatives recently called on their Congressional peers to postpone implementing a rule that would reduce Medicaid Disproportionate Share Hospital (DSH) payments starting on Oct. 1, 2017. The bipartisan letter from Representatives...

EFT Flaws, Paper Enrollment Key Electronic Claims Management Issues

Electronic claims management adoption continues to face challenges related to healthcare Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA), a new Workgroup for Electronic Data Interchange (WEDI) white paper explained....

AHA Questions Accuracy of Combined Post-Acute Care Payment System

CMS and the Office of the Assistant Secretary for Planning and Evaluation (ASPE) should address fundamental issues with the prototype of a combined Medicare post-acute care payment system, a recent Dobson DaVanzo & Associates report stated....

Over 50% of Orgs Lack Adequate Healthcare Cost Reduction Goals

An overwhelming majority of healthcare executives (96 percent) stated that cost transformation is a significant need for their hospital or health system. Yet, over one-half of organizations either do not have a healthcare cost reduction goal...

HHS Offers Special Medicare Reimbursement After Hurricane Irma

In the wake of Hurricane Irma, HHS re-opened the National Disaster Medical System (NDMS) Definitive Care Reimbursement Program, a special Medicare reimbursement program that ensures hospitals and other medical facilities receive payment for the...

Specialists Lack Medicare Alternative Payment Model, MACRA Options

Opportunities for specialists to join a Medicare alternative payment model are severely limited, especially for emergency medicine providers and audiologists, a recent Leavitt Partners report showed. As part of its effort to reimburse one-half...

Revenue Cycle Management, Upgrades Jump to Top Hospital Priority

Hospitals leaders are pushing revenue cycle management to the top of their priority lists in the last quarter of 2017, a recent Black Book Market Research survey uncovered. Almost three-quarters of struggling hospitals are prioritizing revenue...

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