Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid
  • Quality Improvement Projects Save Children’s Hospitals Millions

    June 21, 2018 - Care quality improvements require hospitals to invest their money, time, and staff. The investment may be large, but for two children’s hospitals it paid off, saving the organizations millions and reducing costly accidents and unnecessary utilization. Children’s hospitals manage a unique population compared to general acute care facilities. But their mission is the same as all...

  • Healthcare Mergers, Increased Access to Boost Medical Costs 6%

    June 18, 2018 - PwC’s Health Research Institute (HRI) predicts medical costs for employers to grow 6 percent in 2019 as healthcare mergers and more convenient care access options drive up healthcare costs and utilization. The medical cost trend is consistent with the 5.5 to 7 percent range of the previous five years. But these rates spell trouble for the healthcare industry, explained Barbara Gniewek,...

  • Electronic Claims Management Adoption Could Save Providers $9.5B

    June 14, 2018 - Transitioning from manual to fully electronic claims management would save the healthcare industry $11.1 billion annually, with providers seeing the greatest share of the savings, the fifth annual CAQH Index found. Providers would save approximately $9.5 billion a year by adopting automated processes for just seven common claims management transactions. The estimated savings stemming from...

  • Automated Physician Queries Improve Clinical Documentation at WMHS

    June 12, 2018 - Accurate claims reimbursement hinges on complete clinical documentation, and therefore, quick responses to physician queries regarding medical record documentation and coding. This is especially true in Maryland’s unique hospital reimbursement landscape. For decades, hospitals in Maryland have operated under an all-payer rate-setting system. Under the model, state officials set the rates...


Today's Top Stories

CMS Considers Stark Law Changes to Support Value-Based Care, APMs

CMS is seeking input on how to potentially modify the physician self-referral law, otherwise known as the Stark Law, to encourage value-based reimbursement and care delivery. In a new Request for Information (RFI), the federal agency is calling...

Physician Shortage Drives Boost in Nursing, Physician Assistant Pay

As the physician shortage worsens, provider organizations are increasingly relying on non-physician providers to fill the gap. And they are paying nursing staff, physician assistants, and other employees more to make up for it. The healthcare...

Quality Improvement Projects Save Children’s Hospitals Millions

Care quality improvements require hospitals to invest their money, time, and staff. The investment may be large, but for two children’s hospitals it paid off, saving the organizations millions and reducing costly accidents and unnecessary...

21% of Orgs Do Not Have a Hospital Bad Debt Recovery Process

Even though two-thirds of organizations have up to $10 million in hospital bad debt, some still do not have strategies in place to recover the revenue owed to the organization, a new survey from Sage Growth Partners found. The Baltimore-based...

Key Issues Impacting Two-Sided Risk Accountable Care Organizations

Medicare accountable care organizations (ACOs) operating under two-sided financial risk arrangements save the federal healthcare program more than one-sided risk organizations. But policymakers must address financial incentives, benchmarks, and...

Tariffs to Raise Healthcare Supply Chain Costs, Premier Says

The Trump Administration’s recent move to impose tariffs on goods imported from China could have a serious impact on healthcare supply chains, healthcare improvement company Premier Inc. said in a statement. “Premier is extremely...

Federal Policies to Decrease Hospital Payments by $218B by 2028

Several federal policies since 2010 will reduce hospital payments by a total of $218.2 billion by 2028, a new report from the health economics consulting firm Dobson | DaVanzo and Associates revealed. The report commissioned by the Federation...

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