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Revenue Cycle Management Healthcare News

Full Risk Value-Based Care Key to Treating Vulnerable Patients

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Oak Street Health, a 24-primary care network headquartered in Chicago, aims to rebuild healthcare as it should be using value-based care contracts with full financial risk. The health system’s mission is to deliver personal, equitable,...

Accountable Care Organizations Cut Medicare Spending by $836M

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Accountable care organizations (ACOs) decreased Medicare spending by $836 million in 2016, new data from CMS revealed. As a result, the organizations from four Medicare ACO programs returned about $70.6 million in healthcare savings to the Medicare...

Hospitals, Systems Spend $39B Annually on Regulatory Compliance

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Hospitals, health systems, and post-acute care providers spend almost $39 billion annually on administrative tasks related to regulatory compliance, the American Hospital Association (AHA) reported. “As a result of this extraordinary burden,...

29% of Healthcare Payments Under Alternative Payment Models

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About 29 percent of healthcare payments in 2016 were paid through an alternative payment model, such as shared savings/risk arrangements, bundled payments, or population-based reimbursements, the Health Care Payment Learning and Action Network...

Tenet Cuts 1,300 Jobs as Part of $150M Cost Reduction Initiative

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Tenet Healthcare Corporation recently announced the elimination of approximately 1,300 jobs as part of the health system’s effort to reduce annual operating costs by $150 million by the end of 2018. The Dallas-based health system will implement...

Healthcare Merger, Acquisition Activity to Rise Despite Slow Q3

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Healthcare mergers and acquisition activity in the third quarter of 2017 may be down by 11 percent compared to last year and 6 percent compared to last quarter. But deal volume still reached over 200 announced transactions for the twelfth quarter...

AMGA to Reps: Pass CHRONIC Care Act to Aid ACOs, Team-Based Care

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AMGA recently pushed House Representatives to pass the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017, which would particularly support accountable care organizations (ACO) implementing chronic...

Choosing Wisely Slow to Reduce Low-Value Care, Resource Use

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Participation in the Choosing Wisely campaign has significantly increased since its launch in 2012. But the campaign has yet to realize its goal of decreasing low-value care and resource use, a recent Health Affairs report showed. Researchers...

Health Centers Use Business Tactics to Compete with Private Orgs

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Federally qualified health centers (FQHCs) are the backbone of the healthcare safety net. But rising competition from hospitals and other healthcare organizations may be the straw that breaks that back. FHQCs receive enhanced Medicare and Medicaid...

Pay-for-Performance Models Hurt Safety-Net Hospital Finances

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Medicare pay-for-performance models may disproportionately penalize safety-net hospitals and other organizations that serve the most vulnerable patient populations, a new study in Medical Care found. Hospitals in one of the most socioeconomically...

Value-Based Reimbursement Shift Slows, But CEOs Still Preparing

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Hospital and health system CEOS are gearing up for alternative payment models and population health management, but the transition to value-based reimbursement is taking more time than expected, a recent survey from Deloitte Center for Health...

AMA Pres: Align MIPS Improvement Activities with APM Demands

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Providers can ensure their investments in the Merit-Based Incentive Payment System (MIPS) are worth it by engaging in Improvement Activities and other practice transformations that enhance overall Medicare performance and lead them to the alternative...

Over 1,300 Hospitals Urge CMS to Withdraw 340B Drug Payment Cuts

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Over 1,300 rural hospitals and other healthcare organizations that serve low-income communities added their voices to the growing list of stakeholders opposing proposed payment cuts to the 340B Drug Pricing program. CMS proposed in July 2017...

Trevor Fetter Steps Down as Tenet Healthcare Corp CEO, Director

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Tenet Healthcare Corporation CEO Trevor Fetter stepped down earlier than expected as head of the health system. He also resigned as director of the company, Tenet recently announced. The health system stated in August 2017 that Fetter would no...

4 Strategies for Merit-Based Incentive Payment System Success

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Medicare providers who qualify to participate in MACRA’s Merit-Based Incentive Payment System (MIPS) face up to a 4 percent incentive payment or penalty based on their performance in 2017. Despite MIPS putting revenue at risk, many providers...

GAO Finds Physician Productivity, Staffing Issues at VA Centers

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Incomplete and inconsistent data on physician productivity and staffing challenges the Veteran’s Health Administration’s (VHA) ability to determine if the federal department has enough providers to address the growing health needs...

Home Health Owners Face Charges for Medicare Fraud, Upcoding

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The federal government filed a lawsuit against the two owners of Gateway Health Systems in Chicago for their involvement in a Medicare fraud scheme that cost the federal healthcare program millions, the Department of Justice recently announced....

Using EHR Systems, Supports to Aid MIPS Reporting, Boost Scores

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Delivering high-quality care is already a complicated process for healthcare providers. Understanding, as well as reporting, to MACRA’s Merit-Based Incentive Payment System (MIPS) has made the task even more complex, explained Brad J. Abrams,...

100+ Medical Orgs Want MACRA Implementation Flexibilities Extended

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Over 100 medical organizations recently called on House Representatives to extend MACRA implementation flexibilities that allow HHS leaders to gradually implement full program requirements. The flexibilities should go on for another three years....

382 Hospitals Earn Initial Reconciliation Payments Under CJR Model

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Out of approximately 800 hospitals required to participate in Medicare’s Comprehensive Joint Replacement (CJR) model, 382 facilities will receive a reconciliation payment based on cost savings and care quality, according to preliminary...

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