Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid
  • Healthcare RCM, Medicare Reimbursement Dominate 2017 Stories

    December 14, 2017 - From the Quality Payment Program’s launch to the Affordable Care Act debate, the healthcare finance world saw an abundance of change and uncertainty in 2017. In the face of payment reform and political debates, healthcare leaders focused on ensuring their organizations built a strong healthcare revenue cycle management foundation that could withstand any possible changes. The pursuit...

  • Predictive Analytics Improve Nursing Schedules, Saving Mercy $4.3M

    December 12, 2017 - Even with 40,000 physicians, nurses, and other employees, St. Louis-based Mercy Health still relied on staffing agencies and employee incentives to fill critical nursing schedule gaps until a predictive analytics platform helped operations leaders to identify nursing leakage issues. Nursing leakage is when nurses are not used to their full potential during scheduled shifts, resulting in open...

  • Key Capabilities for Value-Based Reimbursement Models

    December 7, 2017 - Rising healthcare costs, shrinking reimbursement rates, and federal policies are driving hospitals and health systems to adopt value-based reimbursement, according to a new American Hospital Association (AHA) report. But the models are not one-size-fits-all and providers should carefully consider the skills and infrastructure needed to succeed in certain models, including pay-for-performance,...

  • Collaboration Key to Independent Physicians in Value-Based Care

    December 1, 2017 - At first glance, value-based care models appear to work against independent physicians. The risk-based arrangement requires a coordination of services across care continuum — primarily between primary care physicians and specialists but also including providers in hospitals, post-acute care, and home health. As it turns out, independent physicians can have their cake and eat it too by...


Today's Top Stories

State Reviews Beth Israel, Lahey Health Hospital Merger

The proposed hospital merger between Boston health systems Beth Israel Deaconess and Lahey Health is delayed as the state’s Health Policy Commission reviews the deal for healthcare costs, quality, and care access issues, according to local...

60% of Federal Revenue to Come from Risk-Based Models by 2019

Almost 60 percent of federal revenue and 37 percent of commercial revenue will stem from risk-based models by 2019, according to a new AMGA survey. The survey of 74 AMGA medical groups uncovered that Medicare and Medicaid fee-for-service revenue...

Healthcare RCM, Medicare Reimbursement Dominate 2017 Stories

From the Quality Payment Program’s launch to the Affordable Care Act debate, the healthcare finance world saw an abundance of change and uncertainty in 2017. In the face of payment reform and political debates, healthcare leaders focused...

How CMS Improves Primary Care Payments Through Codes, APMs

New medical billing codes for non-face-to-face encounters and alternative payment models are trying to change the way Medicare reimburses for primary care, according to researchers at the Urban Institute’s Health Policy Center. The report,...

High-Risk Patient Management Did Not Drive Early ACO Cost Savings

Care coordination and care management strategies focused on high-risk and chronically ill patients did not drive early cost savings among accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP), a recent Health Affairs...

GAO Offers Steps to Enhance Medicaid, Medicare Fraud Strategy

CMS demonstrates a commitment to preventing and combating Medicaid and Medicare fraud, but the federal agency’s anti-fraud efforts only partially align with the Government Accountability Office’s (GAO) Framework for Managing Fraud...

Predictive Analytics Improve Nursing Schedules, Saving Mercy $4.3M

Even with 40,000 physicians, nurses, and other employees, St. Louis-based Mercy Health still relied on staffing agencies and employee incentives to fill critical nursing schedule gaps until a predictive analytics platform helped operations leaders...

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