Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid
  • Using EHR Systems, Supports to Aid MIPS Reporting, Boost Scores

    October 19, 2017 - Delivering high-quality care is already a complicated process for healthcare providers. Understanding, as well as reporting, to MACRA’s Merit-Based Incentive Payment System (MIPS) has made the task even more complex, explained Brad J. Abrams, DO, FAAD, a dermatologist and Mohs surgeon. CMS designed MIPS to accelerate the value-based reimbursement transition. But many providers, especially...

  • Provider Data Integrity Key to Directory Accuracy, Value-Based Care

    October 16, 2017 - Providers and their payers oftentimes have a love-hate relationship. Payers boost the number of patients walking through physician office doors using provider directories as well as reimburse providers for treating those patients. But navigating how to join a plan’s network just to see those patients and get paid for providing healthcare services involves extensive communication between...

  • AHA Supports Bundled Payment Cancellation, Voices MACRA Concerns

    October 11, 2017 - Despite back the decision by CMS to cancel two bundled payment models and modify another, the American Hospital Association contends that the federal agency is moving a bit too quickly in shifting providers to value-based payment. According to the association, recent changes to the cardiac and surgical hip and femur fracture treatment (SHFFT) bundling programs will squander many of the investments...

  • Physician Advisors Crucial to Navigating Reimbursement Rules

    October 5, 2017 - When physicians are asked why they went into medicine, the classic response is that they wanted to help people. But as value-based reimbursement takes hold and clinical documentation demands increase, providers are finding that the business of healthcare is getting in the way of their care delivery. Physicians are now spending almost six hours a day on EHR data entry, including clinical documentation,...


Today's Top Stories

Home Health Owners Face Charges for Medicare Fraud, Upcoding

The federal government filed a lawsuit against the two owners of Gateway Health Systems in Chicago for their involvement in a Medicare fraud scheme that cost the federal healthcare program millions, the Department of Justice recently announced....

Using EHR Systems, Supports to Aid MIPS Reporting, Boost Scores

Delivering high-quality care is already a complicated process for healthcare providers. Understanding, as well as reporting, to MACRA’s Merit-Based Incentive Payment System (MIPS) has made the task even more complex, explained Brad J. Abrams,...

100+ Medical Orgs Want MACRA Implementation Flexibilities Extended

Over 100 medical organizations recently called on House Representatives to extend MACRA implementation flexibilities that allow HHS leaders to gradually implement full program requirements. The flexibilities should go on for another three years....

382 Hospitals Earn Initial Reconciliation Payments Under CJR Model

Out of approximately 800 hospitals required to participate in Medicare’s Comprehensive Joint Replacement (CJR) model, 382 facilities will receive a reconciliation payment based on cost savings and care quality, according to preliminary...

2017 Hospital Merger Activity Likely to Beat 102 Deals in 2016

Healthcare organizations engaged in 87 hospital merger and partnership transaction so far in 2017, a recent Kaufman Hall analysis showed. The most recent data revealed that 29 hospital merger and partnership deals were announced in the third...

Hospital Mergers Take Two or More Years to Produce Cost Savings

Hospital mergers and acquisitions resulted in immediate decreases in operating expenses per adjusted admission. However, acquired facilities also saw operating revenue decline at a higher rate, leading to falling operating margins for the first...

61% of Next Generation ACOs Earned Shared Savings in 2016

The majority of Next Generation Accountable Care Organizations (ACOs) earned shared savings in the first year of the model, recent data from CMS revealed. Eleven of 18 total Next Generation ACOs will receive a shared savings payment from CMS,...

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