Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Revenue Cycle Management Healthcare News

Hospitals, Blue Cross NC Share Risk with New Value-Based Contract

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Five major health systems recently entered a value-based contract with Blue Cross and Blue Shield of North Carolina (Blue Cross NC) that will hold them financially accountable for total costs of care and overall quality performance. Cone...

Small Hospital Boosts Bottom Line Through Patient Access Automation

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“The patient access area is where everything starts, and that mindset is what led to our success.” That was the sentiment of Deonne Henry, the Vice President of Revenue Cycle at Magnolia Regional Health Center in Mississippi....

Beta Testing Alternative Payment Models to Advance Value-Based Care

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Forcing providers to participate in alternative payment models (APMs) will do little to incentivize providers to make the care delivery and payment changes needed to reduce costs and improve quality, experts at the Center for Healthcare...

67% of MSSP ACOs May Be High-Revenue Under Pathways to Success

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Over two-thirds of Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) would qualify as high-revenue organizations under the new Pathways to Success initiative, a recent Leavitt Partners analysis...

Hospital Prescription Drug Spending Increased 18.5% Per Admission

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Average total hospital prescription drug spending per admission rose by 18.5 percent between the 2015 and 2018 fiscal years, according to a new study conducted by NORC at the University of Chicago. Hospitals spent an average of $555.40...

Congress Wants More on CMMI Alternative Payment Model Development

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The House Committee on Ways and Means is calling on CMS to boost transparency with alternative payment model development in the Center for Medicare and Medicaid Innovation (CMMI), which develops and operates alternative payment and care...

Tenet Healthcare Plans to Outsource 1,000+ Positions to Cut Costs

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The country’s largest for-profit hospital system is looking to significantly expand their offshore healthcare workforce in the next year or two. Local news source Dallas News recently reported that the large hospital system is...

Hospital Merger and Acquisition Deals Got Bigger in 2018

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The average size in revenue of the sellers in hospital merger and acquisition deals grew at a compound annual growth rate (CAGR) of 13.8 percent since 2008, reaching $409 million in 2018, consulting firm Kaufman Hall recently...

Addressing Healthcare Consumerism a Top Priority for Docs in 2019

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2019 will be the year of healthcare consumerism, according to industry experts. As patient financial responsibility increases, revenue cycle and finance leaders are finding it high time to align their business practices with...

CMS Announces Feb 19 Deadline for Pathways to Success Applications

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Accountable care organizations (ACOs) can start their Pathways to Success applications to participate in the initiative replacing the Medicare Shared Savings Program (MSSP) in the summer of 2019. The organizations will have between Jan. 22...

CMS: We Must Do More Than New Healthcare Price Transparency Rule

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Hospitals may have to publish a list of their standard charges online, but that doesn’t have to be their only step to increase healthcare price transparency, CMS Administrator Seema Verma recently stressed. “While many...

Are Hospital Readmissions Reduction Program Results Overstated?

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CMS, researchers, and other healthcare stakeholders have touted the Hospital Readmissions Reduction Program (HRRP) touted as a success. Under the authority of the Affordable Care Act, CMS launched the HRRP in 2010 to incentivize hospitals...

Social Determinants of Health Key to Value-Based Purchasing Success

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We are quickly heading to the value-based purchasing tipping point, according to the Vice President of Network Management at Health Partners Plans in Pennsylvania. “While adoption rates are still relatively low in some regions of...

40% of Revenue Cycle Leaders Don’t Discuss Charge Capture Regularly

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Over three-quarters (78 percent) of revenue cycle leaders at acute care organizations agreed charge capture is essential to an organization’s success, yet most leadership teams only discuss charge capture once a month or less. Those...

Major Healthcare Mergers and Acquisitions Making Waves in 2019

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Increasing financial pressures are pushing providers and even non-provider entities to engage in healthcare merger and acquisition (M&A) activity. Value-based reimbursement, shrinking hospital margins, and record-high healthcare...

Prices Still Responsible for High US Healthcare Spending

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Prices are still the primary reason healthcare spending in the US more than doubled from 2000 to 2016, revealed a new follow-up study to the landmark 2003 article titled “It’s the Prices, Stupid.” The article’s...

Medicare, Medicaid Reimbursement $76.8B Under Hospital Costs

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The largest public payers continue to underpay hospitals, data from the most recent American Hospital Association (AHA) Annual Survey of Hospitals revealed. Medicare and Medicaid reimbursement fell $76.8 billion short of the actual costs...

Opioid Overdose Care Totals $1.94B in Annual Hospital Costs

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The opioid crisis is hitting hospital costs, a recent analysis by healthcare improvement company Premier uncovered. Approximately $1.94 billion in annual hospital costs were attributable to patients who experienced an opioid overdose...

Prescription Drug Spending Higher at 340B Hospitals, Study Finds

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Per-patient prescription drug spending increased by 32.4 percent at hospitals that recently enrolled in the 340B Drug Pricing Program, revealed a new Berkeley Research Group (BRG) study funded by the Pharmaceutical Research and...

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