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

Revenue Cycle Management Healthcare News

CMS Commits to Modernizing Medicare Billing for Office Visits

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Finalizing the consolidation of Medicare billing codes for evaluation and management (E/M) outpatient and office visits is the first step for CMS as the federal agency modernizes the payment structure for office visits, CMS Administrator...

Hospital Bankruptcies Are On the Rise, Hitting Rural Areas Hard

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The healthcare industry experience more than 20 hospital bankruptcies since 2016, and about three-quarters of the distressed hospitals operated in rural areas, law firm Polsinelli recently reported. The Am Law 100 firm tracks Chapter 11...

Patient Leakage Costs Most Healthcare Facilities 10% of Revenue

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Healthcare organizations are losing revenue because they are failing to properly mange referrals and patient leakage, a new survey shows. Forty-three percent of over 100 executives recently surveyed by Sage Growth Partners for Fibroblast...

HRSA Proposes Earlier Start Date for 340B Price Transparency Rule

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HHS plans to move forward the implementation date of a long-delayed 340B price transparency rule that will stop drug manufacturers from overcharging hospitals for drugs purchased under the drug discount program. In a recent notice of...

Exploring Changes to the Quality Payment Program in 2019

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The final 2019 Medicare Physician Fee Schedule (PFS) rule contained a number of changes to evaluation and management (E/M) payment rates, site-neutral payments, and remote patient monitoring coverage. But the rule also included key MACRA...

Hospitals Could Save $25.4B in Healthcare Supply Chain Costs

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Hospitals could save approximately $25.4 billion a year in healthcare supply chain costs by reducing variation and waste, a recent Navigant analysis showed. The analysis of 2,300 hospitals indicated that hospitals and health systems are...

Docs More Supportive of E/M Payment Changes, But Concerns Remain

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Healthcare industry groups remain concerned about collapsing evaluation and management (E/M) payment rates for most office visits, but the groups are generally more supportive of the final E/M payment changes. In the recently finalized...

Would the IPI Model Reduce Medicare Reimbursement for Providers?

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Physicians and hospitals would not see Medicare reimbursement drop under the proposed International Pricing Index (IPI) model, the former Senior Advisor to the Secretary for Drug Pricing Reform recently assured providers. “The model...

AHA, AAMC to Challenge Site-Neutral Payment Policy in Court

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The American Hospital Association (AHA), along with the Association of American Medical Colleges (AAMC) and their member hospitals, plan to bring a lawsuit against CMS for recently released site-neutral payment rules for hospital clinic...

Site-Neutral Payments for Hospital Clinic Visits Starting in 2019

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Hospitals will face site-neutral payments for clinic visits, but not for new clinical families of services, according to the new final 2019 Hospital Outpatient Prospective Payment System (OPPS) rule. CMS recently finalized the contentious...

CMS Delays Collapsing of E/M Payment Rates Until 2021

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CMS will collapse evaluation and management (E/M) payment rates, but not until the 2021 calendar year, according to the recently released final 2019 Physician Fee Schedule (PFS) rule. After industry pushback, the federal agency will delay...

Nurse Compensation Remained Flat Across Most Care Settings

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Nurses did not see a significant boost in average annual compensation in 2017, a recent survey of over 10,200 registered nurses (RNs), and licensed practical nurses (LPNs) revealed. The average earnings of a full-time RN were $81,000 in...

CMS Shifting Home Health to Value-Based Payments Under New Model

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CMS recently finalized a new value-based payment system for home health agencies that would move Medicare reimbursement away from the volume of therapy delivered. Medicare will start to reimburse home health agencies under the...

Hospital-Acquired Conditions Increase Hospital Costs by $2B

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Pressure ulcers, surgical site infections, and other potentially avoidable hospital-acquired conditions (HACs) led to over $2 billion in excess hospital costs in 2016, a recent research brief showed. The research brief from IBM Watson...

AHA: Consolidated Payer Market Influences Hospital Contracting

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“The overwhelming majority of hospitals and health systems are not the drivers in contract negotiations with commercial health insurers,” the American Hospital Association (AHA) recently said in response to a potential FTC...

Aligning the Healthcare Revenue Cycle with Patient Experience

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Improving a patient’s financial experience is key to healthcare revenue cycle management success, according to the Senior Regional Director of Revenue Cycle at Ascension Healthcare. “Moving into the future, we need to focus...

Healthcare Merger and Acquisition Deal Value Dips in Q3 2018

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Healthcare merger and acquisition activity was still trending up in the third quarter of 2018, but deal value dipped, the most recent US Health Services Deals Insights report from PricewaterhouseCoopers (PwC) showed. PwC recorded 261...

Practices Still Averse to Risk-Based Alternative Payment Models

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Physician practices are less willing to participate in alternative payment models with downside financial risk compared to four years ago, revealed a new study from the RAND Corporation and the American Medical Association (AMA). Several...

Optum360, WayStar Named Top Revenue Cycle Management Vendors

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The eighth annual revenue cycle management technology and outsourcing solutions survey from Black Book recently uncovered the top client-rated healthcare revenue cycle management vendors for health systems, hospitals, and physician...

Potential Medicare Reimbursement Demo to Lower Part B Drug Prices

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In an effort to control prescription drug prices, HHS is proposing a mandatory demonstration that would test a new Medicare reimbursement model for certain physician-administered drugs payable under Part B. The proposed International...

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