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

Revenue Cycle Management Healthcare News

Clinicians Less Optimistic About Value-Based Care Than Execs

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Clinicians are more skeptical about the benefits or viability of value-based care and reimbursement compared to healthcare executives, a new survey shows. Only about one-third of clinicians (38 percent) in a recent NEJM Catalyst survey...

Hospital ERP Adoption Up to 38.4% and Will Continue to Climb

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Enterprise resource planning (ERP) adoption remains slow and steady, HIMSS Analytics recently reported. Hospital ERP adoption increased from 18.8 percent of hospitals in 2008 to 38.4 percent of hospitals a decade later, the analysis of...

68% of Hospital Execs Plan for 2018 Revenue Cycle IT Budget Growth

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Fewer healthcare organizations are increasing their revenue cycle IT budgets compared to last year, a new survey shows. The annual Healthcare Financial Management Association (HFMA) and Navigant survey of 107 hospital and health system...

CMS Advances Healthcare Price Transparency With Comparison Tool

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CMS is advancing its healthcare price transparency efforts through a new online tool that allows healthcare consumers to compare Medicare payments and copayments for certain surgical procedures. The recently launched Procedure Price...

Hospital Wage Data Inaccuracies Led to Medicare Reimbursement Issues

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CMS may not be appropriately adjusting Medicare reimbursement to hospitals for local labor prices, a new HHS Office of the Inspector (OIG) report reveals. The HHS watchdog found “significant vulnerabilities” in the hospital...

Patient Perception of Hospital Affiliations Influences Care

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Hospital affiliations can influence patient volume, a new study by the Yale Cancer Center shows. The study recently published in the journal Annals of Surgical Oncology revealed that 85 percent of individuals about to receive complex...

Hospital Operating Income Falls for Two-Thirds of Health Systems

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Health system operating income is deteriorating as hospital expenses continue to grow, according to a recent Navigant analysis. In the three-year analysis of the financial disclosures for 104 prominent health systems that operate...

Medicare Reimbursement Rules Limit Telehealth Adoption

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Telehealth utilization among Medicare beneficiaries is on the rise, but restrictive Medicare reimbursement rules are stifling the adoption of such services, a new report shows. The CMS report on Medicare telehealth utilization between...

Healthcare Disruption Spurs Hospitals to Alter Business Operations

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Eighty-five percent of hospital and health system executives believe the industry is at significant risk for healthcare disruption, and their organizations are preparing their business operations for potential changes to how healthcare...

Hospitals Seek Value-Based Contracting in Healthcare Supply Chain

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Nearly three-quarters of hospital and health system leaders are interested in value-based contracting in the healthcare supply chain, but opportunities to secure contracts with suppliers are lacking, a new survey from Premier Inc....

Atrium Health Settles Anticompetitive Hospital Contracting Claims

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Atrium Health in North Carolina recently agreed to a settlement with the Department of Justice (DoJ) and the North Carolina Office of Attorney General that prohibits the health system from using anticompetitive hospital contracting terms...

Partners, Harvard Pilgrim Suspend Healthcare Merger Talks

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Partners HealthCare, the largest hospital system in Massachusetts, recently halted healthcare merger talks with local insurer Harvard Pilgrim Health Care over concerns the deal would not earn regulatory approval. “Now isn’t...

Investing in Primary Care Delivers Value-Based Care Results

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Supporting primary care will bring value-based care results, asserts Humana’s Chief Medical Officer Roy Beveridge, MD. Value-based arrangements between providers and payers have the lofty, yet admirable goals of improving care...

Medicare Improper Payment Rate Down to 8.12%, Lowest Since 2010

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CMS recently reduced the Medicare improper payment rate as well as the improper payment rates for Medicaid and the Children’s Health Insurance Program (CHIP) for the first time in reporting history, the head of the federal agency...

NP, PA Office Visits Grow 129%, But Healthcare Costs Still Rising

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Office visits to primary care physicians dropped 18 percent from 2012 to 2016 among non-elderly adults with employer-sponsored healthcare coverage, the Health Care Cost Institute (HCCI) recently reported. “The decline in primary...

Consumers Seek Care in New Settings for Lower Healthcare Costs

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Consumers are generally comfortable with seeking routine care in healthcare settings beyond the hospital or their doctor’s office if the healthcare costs are lower, data from PwC’s Health Research Institute (HRI) showed. For...

Hospitals Want Practice Management Systems to Work with EHR, RCM

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Hospitals are seeking customizable practice management systems that integrate with their revenue cycle management and EHR systems, according to a new survey from Black Book Research. Thirty-six percent of hospital system executives said...

Value-Based Reimbursement Reduces Costs 15.6%, Improves Quality

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Value-based reimbursement models are moving the needle on quality and cost, a new analysis from Humana shows. In 2017, medical costs for patients attributed to primary care practices (PCPs) in Humana’s value-based reimbursement...

CMS Paid $4M in Excess GME Medicare Reimbursement, OIG Finds

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Audits performed by the HHS Office of Inspector General (OIG) showed that hospitals received excess Graduate Medical Education (GME) Medicare reimbursement after counting residents and interns as more than one full-time equivalent...

AHA: Tariffs on Chinese Goods Will Impact Hospital Supply Chain

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The American Hospital Association (AHA) recently opposed the Trump Administration’s tariffs on medical equipment and products imported from China, arguing the tariffs would impact the hospital supply chain. “The imposition of...

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