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

Revenue Cycle Management Healthcare News

MSSP ACOs Missed $886M in Potential Revenue By Avoiding Risk

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Accountable care organizations (ACOs) in Track 1 of the Medicare Shared Savings Program (MSSP) could have received an additional $886 million in net payments in 2015 if the organizations took on downside financial risk and earned the 5 percent...

Breaking Down the Top 5 Healthcare Revenue Cycle KPIs

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With value-based reimbursement and healthcare consumerism taking hold of the industry, provider organizations are under pressure to ensure their healthcare revenue cycle is operating at maximum efficiency. To effectively track healthcare revenue...

NQF Eyes Adding Social Risk Factors to Value-Based Purchasing

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In response to stakeholder concerns that value-based purchasing programs unfairly penalize providers who treat greater proportions of disadvantaged patients, the National Quality Forum (NQF) recently endorsed 17 quality measures that address...

Free Health Clinics Face ROI, Clinical Efficiency Obstacles

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Free health clinics help uninsured and low-income individuals access affordable care, but two recent studies show that free clinics may face healthcare costs and clinical efficiency challenges. New research in the Journal of the American Board...

Do Oncology Bundled Payments Promote Low-Value Drug Use?

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Oncology bundled payments are not the answer to lowering prescription drug costs for cancer care delivery, the American Society of Clinical Oncology recently contended. In a position statement on addressing the affordability of cancer drugs,...

Geisinger Lowers Turnover for Healthcare Revenue Cycle Success

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A MAP Award for High Performance in Revenue Cycle from the Healthcare Financial Management Association (HFMA) indicates that a health system achieved outstanding healthcare revenue cycle performance on metrics such as net days in accounts receivable...

Making a Business Case for the Patient-Centered Medical Home

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Transforming primary care practices to patient-centered medical homes (PCMHs) and maintaining National Committee for Quality Assurance (NCQA) recognition cost a large physician network about $2.5 million, or $43,000 per practice, revealed a new...

CMS Considers Behavioral Health Alternative Payment Model

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CMS recently announced its intention to develop an alternative payment model targeting behavioral health services. The federal agency is seeking stakeholder feedback on model development in a public meeting on Sept. 8, 2017, in Baltimore. The...

Greater Non-Physician Staffing Helps Healthcare Revenue Cycle

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Increasing the number of non-physician providers and support staff, such as physician assistants and nurse practitioners, is key to healthcare revenue cycle performance, a recent MGMA survey revealed. The survey of over 2,900 medical groups across...

Is a Chief Primary Care Officer Key to Value-Based Purchasing?

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Developing a Chief Primary Care Medical Officer role should help health systems achieve value-based purchasing success by focusing on establishing care coordination systems and improving key quality measures, argued industry experts in a recent...

Provider Compensation Rises 2.9%, While Productivity Flattens

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Physicians experienced similar physician compensation increases in 2016 compared to last year, with median compensation rising by 2.9 percent after a 3.1 percent boost in 2015, the most recent AMGA Medical Group Compensation and Productivity...

3 Challenges Providers Face with Healthcare Bundled Payments

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Healthcare bundled payments are becoming one of the most popular alternative payment models available to providers. Providers are drawn to the episode-based structure’s ability to decrease healthcare costs while maintaining or improving...

GAO Identifies VA Provider Productivity Measure Shortcomings

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The VA lacks appropriate provider productivity measures and clinical efficiency models to accurately capture medical center performance, the Government Accountability Office (GAO) recently reported. A review of the VA Central Office and six VA...

AMA Backs CMS Diabetes, Legacy Value-Based Purchasing Changes

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The American Medical Association (AMA) recently commended CMS for several recommendations outlined in the recently proposed 2018 Physician Fee Schedule rule. The industry group particularly welcomed a potential Medicare Diabetes Prevention Program...

Beth Israel, Lahey Health Ink Final Healthcare Merger Agreement

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Boston-based Beth Israel Deaconess health system and Lahey Health recently finalized a healthcare merger agreement after about seven months of negotiations. Despite several failed attempts at a healthcare merger in the past, the two health systems...

Understanding the Top 10 Terms of Value-Based Purchasing

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Whether providers favor it or not, the healthcare industry is inevitability moving to value-based purchasing. CMS reported in 2016 that Medicare already linked 30 percent of traditional fee-for-service payments to value-based purchasing models...

Hospital Orgs Oppose Site-Neutral Medicare Reimbursement Cuts

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Several hospital groups recently spoke out against proposed 2018 Medicare reimbursement updates that would reduce site-neutral payments to off-campus provider-based departments from 50 percent of the outpatient rate to 25 percent. CMS recently...

Hospitals, ASCs, 340B Drugs Face Medicare Reimbursement Changes

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CMS recently proposed a rule that would update Medicare reimbursement rates for hospitals and ambulatory surgical centers as well as change some prescription drug rates to 340B hospitals. Hospitals would see a 2 percent Medicare reimbursement...

Small Hospitals, Systems Grapple with Value-Based Reimbursement

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Approximately 67 percent of small hospitals and health systems do not plan on undertaking value-based reimbursement initiatives in 2017, a recent Ernst & Young LLP Advisory Health survey revealed. The survey of 700 healthcare professionals...

Core Competencies for Accountable Care Organization Development

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The National Business Group on Health (NBGH) recently identified the core competencies accountable care organizations (ACOs) should have at each stage of its development. The two resources from NBGH on ACO competencies are meant to help employers...

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