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

Revenue Cycle Management Healthcare News

Do Hospital Mergers, Acquisitions Increase Prices, Reps Ask MedPAC

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Energy and Commerce Committee leaders are calling on the Medicare Payment Advisory Commission (MedPAC) to settle the debate on whether hospital mergers and acquisitions raise prices for patients. In a recent letter to MedPAC’s...

Hospitals Create Drug Company to Combat Drug Shortages, Prices

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Seven health systems are stepping up to the plate to tackle two of the healthcare industry’s most pressing challenges: drug shortages and rising prescription drug rates. Catholic Health Initiatives, HCA Healthcare, Intermountain...

AMA Adds Connected Health CPT Codes, Pushes for Medicare Payment

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The American Medical Association (AMA) updated the Current Procedural Terminology (CPT) code set in 2019 to include new codes for connected health services in an effort to encourage CMS to pay for the services. The 2019 CPT code set...

Bon Secours, Mercy Health Finalize Hospital Merger After 6 Months

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Mercy Health of Ohio and Maryland-based Bon Secours Health System recently announced the completion of their hospital merger deal establishing one of the largest hospital chains and Catholic health systems in the country. In what the...

Developing a 2018 MIPS Reporting Strategy to Avoid a Penalty

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Eligible clinicians can avoid a financial penalty under the Merit-Based Incentive Payment System (MIPS) in 2020 by focusing their reporting on one of three performance categories: Quality, Improvement Activities, or Promoting...

How Next Generation ACOs Built a Foundation for Success

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Employing additional administrative staff, prioritizing care management, and building data analytics capacity were key strategies accountable care organizations (ACOs) implemented to participate in the Next Generation model, CMS recently...

Paying LTCHs Like Skilled Nursing Would Save $4.6B, Analysis Finds

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Eliminating the concept of long-term care hospitals (LTCHs) would save Medicare $4.6 billion per year without harming patient outcomes, a new National Bureau of Economic Research working paper found. Medicare savings would stem from the...

Hospital Financial Performance Lags with Revenue Cycle Outsourcing

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Revenue cycle outsourcing may not be the financial answer hospitals are looking for, according to a recent analysis from the public accounting, consulting, and technology firm Crowe. The analysis of data from more than 1,000 hospitals...

Artificial Intelligence Ensures Payer, Provider Pay Covers Costs

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Artificial intelligence (AI) in healthcare is influencing the next generation of radiology tools and helping to expand access to care in underserved or developing areas. The technology is supporting clinical advancements, but a...

Docs Could Avoid 34% of Out-of-Network Patient Referrals with Data

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Providers recognize the importance of making in-network referrals for care coordination and patient retention. However, 79 percent of physicians still refer patients to other providers outside their health system’s network, a new...

More MSSP ACOs Saved Money, Earned Shared Savings in 2017

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Accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) generated about $314 million in net Medicare savings in 2017, according to new MSSP performance data from CMS. In 2017, 472 ACOs in the largest Medicare...

Shift Admin, QGenda Top Physician Scheduling Vendors, KLAS Reports

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Shift Admin and QGenda are the physician scheduling vendors giving provider organizations their money’s worth for the time saved using the solution, KLAS recently reported. In a series of interviews with over 200 healthcare...

OIG Mulls Anti-Kickback Statute Changes to Boost Value-Based Care

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HHS is looking to make sweeping changes to healthcare fraud and abuse laws. As the comment period for a CMS Request for Information (RFI) on the Stark Law closed, the HHS Office of the Inspector General (OIG) released a new RFI on the...

CFOs Expect Higher Hospital Labor Costs As Staffing Shortages Loom

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About 78 percent of healthcare finance leaders expect hospital labor costs to grow in the next 12 months as the industry faces a worsening shortage of healthcare professionals, a new survey shows. The survey of over 100 CFOs and...

Providers Praise E/M Documentation Changes, Oppose Payment Plans

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Physicians and other healthcare professionals recently welcomed proposed evaluation and management (E/M) documentation changes from CMS that would reduce administrative burden and streamline Medicare billing. Specifically, the American...

CMS to Offer More Flexibility to Risk-Bearing ACOs, Verma Says

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Federal regulations and rules are commonly cited as barriers to implementing value-based reimbursement models. The rules can prevent care coordination and appropriate transitions of care, which negatively impact an accountable care...

Using Text Messages to Improve Healthcare Recruitment, Employment

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Getting qualified healthcare professionals in the door for interviews as quickly as possible is paramount for provider organizations facing a competitive healthcare recruitment and employment market. The healthcare industry is in the...

Next Generation ACOs Save Medicare $62M, Maintain Care Quality

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Accountable care organizations (ACOs) in the Next Generation ACO program produced nearly $62 million in net savings to Medicare while maintaining care quality in 2016, CMS recently reported in the newly released evaluation of the...

Providers Prefer Manual Nurse Scheduling Over Predictive Analytics

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Despite vendors offering predictive analytics and machine learning to support staff and nurse scheduling, provider organizations prefer manually developing their work schedules, a new KLAS report shows. The survey of executives,...

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