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

Revenue Cycle Management Healthcare News

Healthcare Prices, Spending, Employment Decline in Early 2017

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Recent research from the Altarum Institute showed that healthcare prices, spending, and employment are all trending downward after a three-year period of healthcare spending acceleration. Healthcare employment growth declined by 10,000 per month...

Seeing PCP As Main Provider Lowered Medicare Spending by 9%

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Using a primary care provider versus a specialist as the predominant provider of care and care coordination resulted in similar clinical outcomes for Medicare beneficiaries. But Medicare spending was $1,781 lower per beneficiary, a recent Journal...

AHA to IRS: Foster Hospital Participation in Commercial ACOs

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The American Hospital Association (AHA) recently called on leaders from the Department of Treasury and IRS to issue formal guidance that would permit non-profit hospitals to participate in commercial accountable care organizations (ACOs) without...

Top 4 Patient Financial Responsibility Collection Methods

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The top priority for providers is to deliver high-quality healthcare services to their patients. But the recent rise in patient financial responsibility and healthcare consumerism has forced some providers to bump patient collections to the top...

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...

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