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

Revenue Cycle Management Healthcare News

Bundled Payments Rely on Robust Networks, Healthcare Markets

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Healthcare providers are finding that it takes a village to succeed in bundled payment models. From primary care to specialists and post-acute care, providers need an integrated network of provider types and to play to their healthcare market...

Group Purchasing Increases Healthcare Supply Chain Savings

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Group purchasing organizations (GPOs) increased healthcare supply chain savings between 10 percent and 18 percent by reducing transaction costs and supplier prices, a recent Healthcare Supply Chain Association (HSCA) study revealed. The literature...

Provider Profitability Drops Under Biosimilar Use Reimbursement

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Biosimilar use could be the key to lowering healthcare costs associated with biologic treatments, but provider profitability may suffer by as much as $100 million across care settings if providers continue to administer the low-cost alternative,...

PCP Patient Attribution Aids Providers in Value-Based Contracts

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Healthcare providers engaging in value-based contracts with shared savings opportunities earn financial bonuses or receive penalties based on the patients linked to them or their provider system. But which patient attribution model provided the...

Long Wait Times Jeopardize Value-Based Purchasing Revenue

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Fee-for-service payment models promote long patient wait times, but providers may want to consider implementing strategies to reduce wait times to increase market share and revenue under value-based purchasing models, argued two Geisinger Health...

Proactive Healthcare Charge Integrity Captures Missed Revenue

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The key to a successful healthcare charge integrity initiative is the ability to trend chargemaster and coding data, stated Harriett Johnson, the Assistant Director of Revenue Integrity at Novant Health. The trending capability allows health...

41% of Rural Hospitals Operating with Negative Margins

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Approximately 41 percent of rural hospitals faced negative operating margins in 2016, a recent Chartis Group and iVantage Health Analytics study of over 2,100 rural hospitals revealed. Researchers added that rural hospitals located in states...

GAO: Hospital Value-Based Purchasing Model Rewards Low Quality

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A new Government Accountability Office (GAO) report found that CMS gave financial bonuses to hospitals participating in the Hospital Value-Based Purchasing Program despite the facilities earning composite quality scores below the median. Using...

3 Pain Points Affecting Small Practice Healthcare Revenue Cycle

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While working in a small practice allows providers to really understand their patients and their community’s healthcare needs, it can also create unique healthcare revenue cycle management challenges. Small practices come with several advantages....

Hospitals Saw No Effect on Margins After Medicaid Expansion

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The net impact of Medicaid expansion on non-profit hospital finances was close to zero because uncompensated care cost reductions did not offset Medicaid reimbursement shortfalls, a recent AcademyHealth research revealed. After analyzing IRS...

Pediatric Healthcare Costs 35% Less at Community Health Centers

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Pediatric healthcare costs were $1,133 on average among children primarily using community health centers for care versus $1,750 among children seeing other providers, representing a 35 percent difference, a recent Geiger Gibson/RCHN Community...

LA Hospital Pays $42M to Settle Healthcare Fraud, Kickback Case

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Los Angeles-based Pacific Alliance Medical Center recently agreed to pay $42 million in order to settle an ongoing healthcare fraud case involving improper financial relationships between the acute care hospital and referring physicians. According...

Targeting Healthcare Cost Cuts Slows Revenue Cycle Performance

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Health system and hospital revenue cycle fell behind in key performance areas, such as claim denials management and bad debt, because the organizations prioritized healthcare cost reductions over revenue cycle performance, a recent Advisory Board...

Revenue Integrity Top Hospital, Health System Exec Priority

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Hospital and health system leaders plan to prioritize revenue integrity in the next year to improve their healthcare revenue cycle management strategies, according to a recent Healthcare Financial Management Association (HFMA) and Navigant survey....

Accountable Care Organizations Continue to Grow With 11% Boost

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The number of accountable care organizations (ACOs) increased with 92 more organizations operating since the first quarter of 2016, reaching a total of 923 ACOs nationwide by the start of 2017, a recent Health Affairs blogpost stated. The Leavitt...

Surveys Reveal MACRA Implementation, QPP Knowledge Lacking

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Two recent surveys indicated that healthcare provider and executive knowledge of and readiness for MACRA implementation and the Quality Payment Program are lacking despite the value-based reimbursement program launching in January 2017. A new...

Payer Collaboration Key to Value-Based Reimbursement Strategy

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Value-based reimbursement arrangements come in a myriad of shapes and sizes much like provider organizations. But successful value-based contracts will align provider and payer goals for care quality and healthcare utilization as well as establish...

68% of Consumers Did Not Pay Patient Financial Responsibility

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About 68 percent of patients with medical bills of $500 or less did not fully pay their patient financial responsibility to hospitals in 2016, according to a recent TransUnion Health study. The proportion of individuals failing to pay off full...

Industry Orgs Back 2018 MACRA Implementation Flexibilities

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Healthcare industry organizations largely applauded the recently-released 2018 MACRA implementation proposal from CMS. The medical organizations commended the federal agency’s continuation of the transition year into 2018 as well as the...

Implementing Value-Based Healthcare Revenue Cycle Management

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To align healthcare revenue cycle with value-based reimbursement, healthcare organizations should start by breaking down clinical and financial siloes established by fee-for-service payment models, agreed presenters at Xtelligent Media’s...

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