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

Revenue Cycle Management Healthcare News

Post-Acute Care Costs by Market Affect Bundled Payment Models

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A recent study in Medical Care found that post-acute care variations by healthcare market significantly impacted total episode costs in 30-day hip and knee replacement bundled payment models, suggesting financial strategies should focus on high-utilizers...

CMS Opens Comprehensive Primary Care Plus Apps in 4 Regions

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CMS recently announced that the second round of the Comprehensive Primary Care Plus (CPC+) alternative payment model will launch in four regions in 2018. The four regions are Louisiana, Nebraska, North Dakota, and the greater Buffalo area of...

Healthcare Framework Aims to Drop Low-Value Resource Use, Costs

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Healthcare organizations looking to reduce low-value resource use and healthcare costs should implement a framework that addresses the patient and clinician interaction, according to a recent Journal of Hospital Medicine report. Four physicians...

10 Orgs Call for Medicare Advantage APMs to Qualify for MACRA

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A coalition of ten healthcare industry groups recently urged HHS Secretary Tom Price to weigh risk-based Medicare Advantage alternative payment models the same as Advanced Alternative Payment Models under MACRA. Qualifying participants in MACRA’s...

Physician Alignment Drives Healthcare Revenue Cycle Progress

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Hospital and health system leaders frequently rank decreasing healthcare costs and increasing efficiency as their top concerns year-after-year. But many healthcare organizations have struggled to implement and sustain healthcare cost reduction...

Key Capabilities for Population-Based Alternative Payment Models

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To succeed in population-based alternative payment models with two-sided financial risk, health systems should embrace assuming the role of the payer and work to get all staff on board with the model, suggested Jackie Selby, a healthcare and...

Execs Say Value-Based Purchasing to Hit Tipping Point by 2020

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Over one-half (55 percent) of healthcare executives surveyed after the recent presidential election stated that the industry should reach the value-based purchasing tipping point before 2020, a recent Lazard report revealed. The survey of 203...

Will Behavioral Economics Improve Alternative Payment Models?

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Alternative payment models may need to account for the behavioral economics behind provider prescribing habits to effectively reduce healthcare costs from expensive medications and treatments, a recent American Journal of Managed Care study stated....

Engaging Providers Key to Value-Based Reimbursement Adoption

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Nearly three-quarters (73 percent) of providers prefer a fee-for-service model over value-based reimbursement structures even though almost one-half acknowledged that the traditional payment model contributed to higher healthcare costs, a recent...

Cloud-Based Healthcare Supply Chain Management Drives Market

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The healthcare supply chain management market should be worth up to $2.22 billion by 2021 as healthcare organizations face increasing pressure to advance operational efficiency and profitability, according to a recent Markets and Markets report....

Medicare Appeals Backlog Delays Decision Process By 4.5 Years

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Hospitals waited an average of 1,663.3 days, or a little over 4.5 years, to conclude the Medicare reimbursement audit and appeals process because of the extensive Medicare appeals backlog, a recent Journal of Hospital Medicine study uncovered....

3 Best Practices for Hospital Claim Denials Management

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Healthcare cost control continued to top hospital priority lists in 2017. But hospital leaders may be leaving millions of dollars on the table because of inefficient claim denials management processes. Claim denial rates ranged between 0.54 percent...

Creating Alternative Payment Models to Support Health Centers

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Healthcare stakeholders and lawmakers should encourage community health centers to engage in alternative payment models to financially incentivize providers to improve safety-net care, a recent Journal of the American Medical Association report...

Do NP, PA Ordering Habits Lead to Higher Healthcare Costs?

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Nurse practitioners and physician assistants did not contribute to higher healthcare costs by ordering more ancillary or expensive services compared to primary care providers, a recent American Journal of Managed Care study uncovered. The analysis...

77% of Practices Seek MIPS Compliance Tech for MACRA Support

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Approximately 77 percent of practices of three or more clinicians are looking to purchase Merit-Based Incentive Payment System (MIPS) compliance technology by the last quarter of 2017 to overcome MACRA implementation challenges, a recent Black...

NYC Hospital Adds Epic Revenue Cycle Management to EHR System

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NYC Health and Hospitals Corporation (NYCHHC) recently selected to implement an Epic healthcare revenue cycle management solution to help the health system boost adjusted patient revenue by another 5 percent. The largest public health system...

56% of Top Performing Med Groups Plan Value-Based Purchasing

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About 56 percent of medical groups that were financially high-performing have a plan for a value-based purchasing transition versus just 32 percent of medical groups falling behind with healthcare revenue cycle management, a recent CareCloud...

House Reps Address Physician Shortage in Medicare Residency Bill

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House representatives Joseph Crowley (D-NY) and Ryan Costello (R-PA) recently introduced legislation that aims to resolve physician shortage challenges by adding more Medicare-funded residency positions. A summary of the Resident Physician Shortage...

Post-Acute Care Network Key to Value-Based Purchasing Success

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Health systems should develop a post-acute care network and strategy to succeed in value-based purchasing models, a recent Deloitte survey indicated. The survey of 36 executives from health systems, payers, post-acute care organizations, and...

High-Cost Patients Widely Distributed Across Hospitals, Markets

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A recent American Journal of Managed Care study attempting to understand why some patients incur higher healthcare costs than others found that high-cost patients were evenly spread across providers and healthcare markets. Using a 20 percent...

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