Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid
  • How Mercy Improved Care Transitions for Risk-Based Care Success

    January 22, 2018 - For the thousands of patients released from their 23 acute care hospitals a year, Mercy Health ensures that each patient receives the highest value care. But there is only so much providers can do within the walls of their health system to extend that high-value care through care transitions during the post-acute care period. Effective care transitions are key to not only improving Mercy Health’s...

  • AHA, AMA and Others Offer 5 Prior Authorization Reform Strategies

    January 18, 2018 - Six industry groups representing providers, payers, and pharmacists recently partnered to identify strategies to improve prior authorization processes, such as decreasing the number of providers subject to prior authorizations and automating prior authorization processes. Prior authorizations create administrative burdens for providers, patients, and payers, the American Hospital Association...

  • Exploring the Bundled Payments for Care Improvement Advanced Model

    January 15, 2018 - CMS recently unveiled the Bundled Payments for Care Improvement (BPCI) Advanced initiative, a new bundled payments model that will include inpatient and outpatient clinical episodes and qualify as an Advanced Alternative Payment Model (APM) under MACRA. The newest CMS Innovation Center addition will build off the existing Bundled Payments for Care Improvement initiative, which launched in...

  • Voluntary Bundled Payments Launch, HHS Nominee Backs Mandatory APMs

    January 10, 2018 - CMS announced a new voluntary bundled payments opportunity starting in late 2018 on the same day that HHS Secretary nominee Alex Azar seemingly backed mandatory alternative payment models during a Senate Finance committee hearing. The new voluntary model, known as the Bundled Payments for Care Improvement Advanced (BPCI Advanced), builds on the existing BPCI initiative. Providers can elect...


Today's Top Stories

CMS Welcomes 58 Next Generation ACO Model Participants in 2018

In 2018, the Next Generation ACO model will have a total of 58 participating accountable care organizations (ACOs), up from 45 organizations the previous year, CMS recently announced on the program’s Innovation Center webpage. The class...

AMGA: Align Medicare Advantage, APMs to Promote Value-Based Care

If CMS moves forward with relaxing Medicare Advantage benefit requirements, then the federal agency should offer the same flexibilities to providers and beneficiaries in Medicare Part B alternative payment models, such as accountable care organizations...

Health Systems Form Drug Company to Combat Rising Costs, Shortages

Intermountain Healthcare, Ascension, SSM Health, and Trinity Health recently announced that they will create a non-profit generic drug company to reduce prescription costs and alleviate critical drug shortages. With consulting services with the...

How Mercy Improved Care Transitions for Risk-Based Care Success

For the thousands of patients released from their 23 acute care hospitals a year, Mercy Health ensures that each patient receives the highest value care. But there is only so much providers can do within the walls of their health system to extend...

Risk-Averse MSSP ACOs Missed $966M By Not Assuming Downside Risk

Accountable care organizations (ACOs) in the non-risk bearing track of the Medicare Shared Savings Program (MSSP) could have boosted their bottom lines by an additional $966 million in net payments in 2016 if they had assumed downside risk in...

Global Healthcare RCM Software Market to Reach $43.3B by 2022

The global market for healthcare revenue cycle management software will grow at a compound annual growth (CAGR) rate of 6.9 percent from 2017 to 2022, researchers from Future Market Insights recently predicted. At that growth rate, they estimate...

AHA, AMA and Others Offer 5 Prior Authorization Reform Strategies

Six industry groups representing providers, payers, and pharmacists recently partnered to identify strategies to improve prior authorization processes, such as decreasing the number of providers subject to prior authorizations and automating...

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