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

Revenue Cycle Management Healthcare News

52% of Provider Compensation Bonuses Tied to RVUs, Not Quality

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Approximately 52 percent of provider compensation offers with a production bonus in 2017 based the additional pay on relative value units (RVUs), while just 39 percent used quality metrics, a recent Merritt Hawkins survey found. The study of...

Patient Engagement Critical to Bundled Payment Model Success

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Under bundled payment models, healthcare providers take on the clinical and financial risk payers traditionally managed. But providers at OrthoCarolina found that patients also play a major role in improving care quality and decreasing healthcare...

Healthcare Employment Shifting to Hospital-Employed Providers

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Physician practice owners no longer make up the majority of patient care providers, a recent American Medical Association (AMA) healthcare employment study revealed. Approximately 47 percent of patient care providers had a full or part ownership...

86% of Providers Saw Prior Authorization Requirements Increase

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Approximately 86 percent of medical practice leaders reported that prior authorization requirements have increased over the past year, a recent MGMA survey of over 1,000 leaders found. Only 3 percent stated that prior authorization requirements...

Providers Lack Tools, Payer Alignment for Value-Based Purchasing

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Healthcare providers still lack the necessary tools for value-based purchasing success with only 43 percent of providers reporting that they have access to the appropriate solutions, a recent Quest Diagnostics and Inovalon survey uncovered. However,...

Payment Plans Tackle Hospital Patient Collection Challenges

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The growing popularity of high-deductible health plans has wedged many healthcare organizations between a rock and a hard place. Healthcare organizations are struggling to implement patient collection strategies that acquire all of a patient’s...

Count Medicare Advantage Patients for Advanced APMs, Orgs Say

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Eligible clinicians participating in appropriate alternative payment models under a Medicare Advantage plan should qualify for Advanced Alternative Payment Model (Advanced APM) incentive payments in 2019, the AMGA and nine other healthcare industry...

Lab Experts Help Providers Reduce Low-Value Resource Use, Costs

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Collaboration between laboratory medicine experts and clinicians is critical to reducing unnecessary and low-value resource use for value-based purchasing success, the American Association For Clinical Chemistry (AACC) recently stated. “The...

Only 40% of ED Providers Identified Accurate Healthcare Costs

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Emergency department providers have little understanding of the healthcare costs associated with common visits, a recent Journal of the American Osteopathic Association study revealed. The survey of over 400 healthcare professionals working in...

Incorporating Population Health in Next Gen of Bundled Payments

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The next generation of bundled payments should focus on population health management, researchers recently argued in a Journal of the American Medical Association report. Bundled payment models can align with population health management by extending...

87% of Practices Not Adding Staff for MACRA Implementation

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About 87 percent of physician practices do not plan on hiring additional healthcare staff to help with MACRA implementation, a recent Physicians Practice survey showed. The survey of over 1,000 practice managers and physicians revealed that most...

Commitment Key to Successful Value-Based Reimbursement Adoption

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It is time for healthcare providers to move past understanding the concept and start the value-based reimbursement adoption process. Otherwise, they may face profitability decreases from operating both fee-for-service and alternative payment...

Data Analytics, Collaboration Critical to MACRA Implementation

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Healthcare providers need to restructure many aspects of their organization for successful MACRA implementation, including data analytics capabilities, financial risk assumption, stakeholder partnerships, and patient engagement strategies, according...

2016 Medicaid, Medicare Improper Payments Over Regulatory Cap

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A recent Office of the Inspector General (OIG) report revealed that the rates of Medicaid and Medicare improper payments in 2016 exceeded the legislative threshold of less than 10 percent. The improper payment rate for Medicare fee-for-service...

AHA Urges Rural, Post-Acute Care Medicare Reimbursement Reform

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In a Congressional hearing on the current status of Medicare reimbursement systems, the American Hospital Association (AHA) urged lawmakers to focus on rural hospital and post-acute care payments. MACRA extended a number of key Medicare reimbursement...

Surviving Solo with Independent Practice Association Support

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Healthcare reform and market forces are driving more independent practice leaders to consolidate with larger hospitals or health systems. But an independent practice association, like Vermont’s HealthFirst, can help solo providers leverage...

Medicare Cardiac, Ortho Bundled Payments Delayed Until 2018

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CMS recently delayed the launch date of three mandatory Medicare cardiac and orthopedic bundled payment models and the Cardiac Rehabilitation Incentive Payment program from May 20, 2017, to Jan. 1, 2018. The final ruling from the federal agency...

Execs To Continue Value-Based Purchasing Despite Uncertainty

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Despite a possible Affordable Care Act repeal, healthcare executives still plan to stay the course with value-based purchasing implementation and healthcare cost reduction initiatives, a recent BDC Advisors survey reported. Although the C-suite...

Third MI Provider Convicted in $17.1M Healthcare Fraud Case

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Healthcare fraud prevention and prosecution will continue to be a major area of focus for the Department of Justice (DoJ), Acting Assistant Attorney General Kenneth A. Blanco recently told the American Bar Association. With healthcare fraud draining...

How Clinicians Add Value to Healthcare Supply Chain Management

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Engaging clinical staff is key to adding value to healthcare supply chain management, according to three supply chain leaders at MaineHealth, a recent ECRI Institute Healthcare Supply Chain Achievement award recipient. The healthcare network...

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