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

Revenue Cycle Management Healthcare News

Physician Compensation for Specialists 45.6% More than for PCPs

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According to a recent Medscape survey, physician compensation for specialists was 45.6 percent more than what primary care providers earned in the past year. The survey of over 19,200 physicians in 27 specialists uncovered that the average physician...

Healthcare Costs Rise With Regional Post-Acute Care Variations

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Despite receiving similar post-acute care services overall, rural hospital patients tend to undergo more skilled nursing facility treatment than home health care versus urban hospital patients, contributing to higher healthcare costs, according...

CMS Pauses Home Health Pre-Claim Review Demonstration

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CMS recently halted the home health Pre-Claim Review demonstration in Illinois for 30 days and the program will not expand to Florida as expected in April 2017, according to the federal agency’s website. “After March 31, 2017, and...

AMGA Supports 15% Limit for Medicare Advantage Encounter Data

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AMGA recently applauded CMS for further reducing the percentage of encounter data to be used to determine Medicare Advantage enrollee risk scores from 25 percent in the proposed rule to 15 percent in the final 2018 performance year update. “It...

MIPS Reporting Success Depends on Choosing Suitable Measures

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For Merit-Based Incentive Payment System (MIPS) reporting success, eligible clinicians should report on quality measures that they know their practice already performs well on, advised Michael Abrams, MA, a managing partner at the healthcare...

AHA: Post-Acute Care Medicare Reimbursement Reform Needs Time

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Later this month, the Medicare Payment Advisory Commission (MedPAC) plans to vote on a draft recommendation to Congress that would accelerate the development and implementation of a unified Medicare reimbursement system for four post-acute care...

Lean Primary Care Improves Physician Productivity, Costs

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A recent American Journal of Managed Care study showed that implementing a Lean primary care model resulted in operational cost reductions, physician productivity improvements, and higher patient satisfaction scores. “Our findings indicate...

Is Radiation Overuse Contributing to Higher Healthcare Costs?

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Oncologists could have saved over $164 million in healthcare costs if they had adhered to clinical guidelines and prescribed shorter radiation treatment for some breast cancer patients, a recent Journal of Oncology Practice study revealed. Only...

Patient Collection Rates Drop as Out-of-Pocket Costs Go Up

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Hospitals collect significantly less from patients with higher out-of-pocket costs, a Crowe Horwath study confirmed. The study revealed that collection rates for patient accounts with balances greater than $5,000 were four times lower than collection...

Bundled Payment Models Here to Stay Despite CMS Program Delays

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CMS may have issued three-month delays for several new healthcare bundled payment models, but providers should still anticipate the shift to value-based purchasing through the episodic alternative payment model, said Colin Luke, a partner at...

Nurse Practitioner, Physician Assistant Salary Grew in 2016

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As nurse practitioner and physician assistant salary rates continue to rise, a recent PracticeMatch survey found that more advanced practitioners are also increasingly enjoying their jobs. The survey of over 1,000 nurse practitioners and physician...

Oncologist Org Opposes MedPAC Medicare Reimbursement Changes

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The Community Oncology Alliance (COA) recently expressed concerns that proposed Medicare reimbursement changes for Part B services from the Medicare Payment Advisory Commission (MedPAC) would drive cancer care to more higher-cost settings. “MedPAC...

IL Supreme Court Maintains Non-Profit Hospital Tax Exemption

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The Illinois Supreme Court recently legally voided an appellate court’s decision that non-profit hospital tax exemption was unconstitutional. In Illinois, non-profit hospitals qualify for property tax exemption if the value of all charitable...

AMGA President, CEO Donald W. Fisher, PhD, Passes at 71

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AMGA President and CEO, Donald W. Fisher, PhD, CAE, passed earlier this week after battling cancer, the healthcare industry group reported. Fisher, who was 71 years old, had led the organization since 1980. “Don leaves a professional and...

OIG Releases Healthcare Fraud Compliance Program Guidelines

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The Office of the Inspector General (OIG) recently published guidelines on how healthcare organizations can measure the effectiveness of their healthcare fraud compliance programs. The resource guide explains how healthcare organizations of all...

NJ Quality Improvement Model Lowers Healthcare Costs by $641M

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Hospitals in New Jersey reduced healthcare costs by over $641 million between 2012 and 2016 after implementing a statewide quality improvement initiative, the New Jersey Hospital Association (NJHA) recently reported. Under the Affordable Care...

Out-of-Pocket Healthcare Spending Rose 65% at Freestanding EDs

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Freestanding emergency departments are becoming a popular alternative care setting for common conditions, such as upper respiratory infections. But a recent study in the Annals of Emergency Medicine found that median prices for out-of-pocketing...

64% of Healthcare Providers Not Ready for MACRA Implementation

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Even though MACRA’s Quality Payment Program started on Jan. 1, approximately 64 percent of healthcare providers stated that they were either unprepared or very unprepared for MACRA implementation in a February 2017 survey by Stoltenberg...

How to Prepare for Alternative Payment Model Implementation

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Implementing interoperable health IT infrastructure and a staffing model that aligns with value-based care requirements are key to successfully participating in an alternative payment model, Marjie Harbrecht, MD, a Medical Group Management...

NAM Advises Leaders to Prioritize Value-Based Purchasing Reform

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In a new report, the National Academy of Medicine (NAM) named value-based purchasing as one of four action priorities for healthcare stakeholders in 2017. To implement more value-based purchasing models, NAM suggested that stakeholders focus...

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