Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid
  • A Provider-Sponsored Health Plan Is A Hospital’s Natural Next Step

    July 16, 2018 - Many hospitals and health systems are bypassing the ultimate opportunity to gain greater control of the outcomes and costs of their patients. That opportunity is developing their own provider-sponsored health plan, according to Geisinger Health Plan’s Chief Financial Officer. “It’s important to think about how important hospitals are to local communities. In many health systems,...

  • CMS Proposes 2019 Physician Payment, Quality Payment Program Changes

    July 12, 2018 - CMS recently proposed major changes to Medicare physician payments and the Quality Payment Program to reduce the administrative burden of medical billing. The potential changes in the Medicare Physician Fee Schedule would save individual clinicians 51 hours per year if 40 percent of their patients are in Medicare, while proposed changes to the Quality Payment Program would collectively save...

  • Key Terms, Components of Payer Contracts Providers Should Know

    July 11, 2018 - Providers are in the business of keeping their patients healthy. But confusing payer contracts riddled with “legalese” and other complicated provisions can get in the way of improving patient outcomes. Payer contracts define and explain a provider’s reimbursement arrangement for delivering healthcare services to patients covered by a specific health plan. The contracts cover...

  • CMS to Waive MIPS for Providers in At-Risk Medicare Advantage Plans

    July 2, 2018 - CMS recently announced that it advanced a demonstration that would waive Merit-Based Incentive Payment System (MIPS) requirements for eligible clinicians participating in at-risk Medicare Advantage plans. If approved, the Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) demonstration would apply to eligible clinicians sufficiently involved in Medicare Advantage plans that...


Today's Top Stories

CMS Misses Chance to Move Physician Pay, QPP to Value, AMGA Says

CMS recently proposed several changes to Medicare physician payments and MACRA’s Quality Payment Program to reduce medical billing and administrative burden. But initial reactions from medical group associations have not been positive....

Docs, Payer Execs Agree Providers Lack Tools for Value-Based Care

A lack of technology and patient data may be stalling or even reversing the value-based care transition, a new survey of primary care physicians and health plan executives revealed. “Stalled Progress on the Path to Value-Based Care,”...

A Provider-Sponsored Health Plan Is A Hospital’s Natural Next Step

Many hospitals and health systems are bypassing the ultimate opportunity to gain greater control of the outcomes and costs of their patients. That opportunity is developing their own provider-sponsored health plan, according to Geisinger Health...

Who Should be Held Accountable for Healthcare Costs?

While the recent growth in patient financial responsibility has providers thinking about healthcare costs when making care decisions, many still do not think they should be held accountable for the costs of care, a recent survey showed. A new...

Beth Israel, Lahey Health Hospital Merger May Up Costs, MA AG Says

The proposed hospital merger between Beth Israel Deaconess Medical Center and Lahey Health is facing pushback from the Massachusetts Attorney General despite a previous endorsement from a key state board. Local news sources are reporting that...

CMS Proposes 2019 Physician Payment, Quality Payment Program Changes

CMS recently proposed major changes to Medicare physician payments and the Quality Payment Program to reduce the administrative burden of medical billing. The potential changes in the Medicare Physician Fee Schedule would save individual clinicians...

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