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

Revenue Cycle Management Healthcare News

ACOs Relax Post-Acute Care Rules to Improve Care, Reduce Costs

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Ensuring patients receive the right post-acute care at the right time is key to controlling costs in accountable care organizations (ACOs) and other population-based alternative payment models. With this in mind, Vermont’s statewide...

CMS Initiative to Create Pediatric APMs to Address Opioid Crisis

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A new CMS Innovation Center initiative will call on local stakeholders and Medicaid agencies to develop alternative payment models that address the impact of the opioid crisis for children, CMS recently announced. Medicaid and local...

Group Purchasing Saves Hospitals Up to 18% of Supply Chain Costs

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Group purchasing organizations (GPOs) are saving hospitals and other healthcare facilities between 10 to 18 percent, a new report revealed. The Healthcare Supply Chain Association’s (HSCA) second annual report on GPO value found...

Medical Practices to Focus on Staff, Patient Retention, MGMA Finds

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Medical practices are putting staff and patient retention efforts on the top of their priority lists, a new report from the Medical Group Management Association (MGMA) showed. MGMA’s “2018 MGMA DataDive Practice...

When Claims Reimbursement Doesn’t Cover Healthcare Innovation

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Implementing healthcare innovations that improve care quality is key to boosting patient experience and care quality, but what happens when claims reimbursement doesn’t cover the use of the latest and greatest services? This is the...

HHS to Clear Medicare Appeals Backlog by 2022, Court Docs Show

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HHS is making significant progress with eliminating the growing Medicare appeals backlog, according to recent court documents. The federal department projects Medicare to clear the backlog by the 2022 fiscal year. A 70 percent increase in...

Hospital Mergers Produce Modest Healthcare Supply Chain Savings

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Hospitals only save approximately 1.5 percent annually on common expenses in the healthcare supply chain after a hospital merger, new research shows. The new working paper from the National Bureau of Economic Research found that actual...

Healthcare Costs, Affordability A Major Challenge for Patients

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According to several new studies, Americans are struggling with rising healthcare costs and paying for their patient financial responsibility, which could spell trouble for providers trying to collect revenue that is owed to...

Value-Based Experience, Robust EHR Use Key Factors to ACO Success

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A collaborative culture, prior value-based reimbursement experience, and robust EHR use are among the top factors contributing to accountable care organization (ACO) success, according to a new report from the Patient-Centered Primary Care...

KLAS: Business Intelligence Use Varies, Epic Systems Leads Adoption

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Health IT giant Epic Systems has the deepest adoption of healthcare business intelligence solutions, but healthcare organizations are also increasingly seeking the advanced data analytics tools offered by Jvion, HBI Solutions, and other...

Do Proposed Quality Payment Program Changes Support Specialists?

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The American Society of Clinical Oncology (ASCO) recently expressed their concerns with proposed Quality Payment Program changes, arguing the potential implementation policies for the third year of the program do not align with specialty...

After a Slow 2017, ACOs Grow and Expand Their Contracts in 2018

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The number of accountable care organizations (ACOs) continued to grow in 2018, as did the number of contracts the organizations entered, a new report from Leavitt Partners and the Accountable Care Learning Collaborative uncovered. From...

Academic Medical Centers Receive More Value-Based Penalties

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Academic medical centers (AMCs) are key members of the healthcare industry, engaging in medical research, uncovering clinical breakthroughs, and training future providers. However, a new analysis by Navigant shows that the organizations...

Medicaid Could Save $4.8B Through Electronic Claims Management

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State Medicaid programs are significantly lagging with the adoption of fully electronic claim submissions, claim reimbursements, prior authorizations, and other claims management processes, according to a new Council for Affordable Quality...

MI Hospital System Pays $84.5M to Resolve Healthcare Fraud Claims

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A regional hospital system in the Detroit, Michigan area agreed to pay the federal government over $84 million to resolve allegations that the system violated the Anti-Kickback Statute and the physician-self referral law. The federal...

Leading Accountable Care Organization Group Opposes MSSP Overhaul

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The proposal to overhaul the Medicare Shared Savings Program (MSSP) would significantly harm the accountable care organization (ACO) movement, the National Association of ACOs (NAACOS) recently stated. “The administration’s...

Paperless Medical Billing Key to Boosting Patient Collections

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In the age of smartphones, tablets, and other technologies that put information literally in the palm of our hands, why do doctors still rely on paper to reach their patients for medical billing purposes? That was the question Max...

Prescription Drug Rate Growth to Slow in 2019, Increasing 4.92%

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Hospitals and health systems should anticipate prescription drug rates to increase by 4.92 percent in 2019, researchers from the healthcare improvement company Vizient recently estimated. Prescription drug rates for hospitals and health...

CMS Plans to Transform MSSP to Encourage ACOs to Assume More Risk

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CMS recently proposed an overhaul of Medicare’s largest accountable care organization (ACO) program, transforming it from the Medicare Shared Savings Program (MSSP) to the Pathways to Success initiative. The redesigned MSSP program...

Employers Play Bigger Role in Value-Based Reimbursement Transition

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Providers wanting to expand their value-based reimbursement contracts may want to look to the employer-sponsored health plan market, according to a new report from the Duke-Margolis Center for Health Policy and the Robert Wood Johnson...

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