Revenue Cycle Management Healthcare News

Value-Based Payment Models May Help Curb High Healthcare Spending

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As healthcare spending escalates in the US, stakeholders have started looking at value-based payment models to address rising costs, but many payments are still tied to fee-for-service models,...

AHA, AMA Urge Congress to Prevent Medicare PAYGO Sequester

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Seven national healthcare organizations, including the American Hospital Association (AHA) and the American Medical Association (AMA), have asked Congress to prevent the Statutory Pay-As-You-Go (PAYGO)...

Patient Payment Solutions Not Living Up to Provider Expectations

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Most providers have seen an implementation of a patient payment solution over the past five years. However, 30 percent felt the implementations were not successful and only 58 percent reported high...

Rising Expenses, Negative Margins Drove Poor Hospital Finances

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Hospitals’ poor financial performances continued in October, driven by negative operating margins and rising expenses, according to data from Kaufman Hall. The National Hospital Flash Report...

HHS Proposes Changes to 340B Administrative Dispute Resolution

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HHS has proposed revisions to the 2020 final rule on the 340B Administrative Dispute Resolution (ADR) process to modify policy and operational challenges. The ADR process in the 340B Drug Pricing...

Inflation Driving Financial Challenges for Consumers, Health Systems

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More than 70 million adults feel unprepared to pay for healthcare costs, while health systems are facing a tight labor market and ongoing supply chain issues, highlighting the financial repercussions...

House Committee Requests Changes to Final Surprise Billing Rule

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Leaders of the House Committee on Ways and Means have voiced concerns that the final surprise billing rule on the independent dispute resolution (IDR) process continues to violate the No Surprises...

NY Gov. Signs Legislation Prohibiting Property Liens Over Medical Debt

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New York Governor Kathy Hochul has signed legislation aiming to protect patients with medical debt from facing wage garnishment or liens on their property. “No one should face the threat of...

APG Direct Contracting Entities Helped Save Medicare $70M in 2021

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The Global and Professional Direct Contracting Model generated $70 million in net savings for the Medicare program in 2021, with several member organizations of America’s Physician Groups (APG)...

Sanford Health, Fairview Health Systems Plan to Form Integrated Health System

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Sanford Health and Fairview Health Services have signed a letter of intent to form an integrated health system that aims to improve access to quality care for rural and urban populations. “Our...

Accounting for Observation Stays Shrunk Hospital Readmission Reductions

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The decrease in readmission rates associated with the Hospital Readmissions Reduction Program (HRRP) was smaller after accounting for observation stays, indicating that the value-based program may be...

CMS Offers Up New Hospital Price Transparency Resources

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CMS has published on its website new hospital price transparency resources to help hospitals meet the federal requirement to make certain standard charges available to the public via a machine-readable...

Butler Health System, Excela Health Enter Definitive Merger Agreement

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Butler Health System (BHS) and Excela Health have entered into a definitive merger agreement to form a new hospital system that will serve 750,000 patients in western Pennsylvania. The agreement comes...

22 States Want CMS to Repeal Healthcare Vaccine Mandate

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The healthcare vaccine mandate from CMS is no longer needed, according to attorneys general from nearly half the states. A coalition of attorneys general from 22 states have filed a petition under the...

HRSA Opens Portal for Late Provider Relief Fund Reporting

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The Health Resources and Services Administration (HRSA) has opened the Provider Relief Fund (PRF) portal to allow late reporting from healthcare providers on how they used PRF payments. The portal is...

MGMA Requests Modifications of Good Faith Estimate Requirements

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The Medical Group Management Association (MGMA) has asked HHS, the Department of Labor, and the Department of the Treasury (the Departments) to modify the good faith estimate (GFE) and advanced...

Younger Primary Care Physicians Seeing High Levels of Burnout, Stress

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Primary care physicians have faced significant levels of stress since the start of the COVID-19 pandemic, with more than half of physicians under 55 experiencing emotional distress and burnout,...

KLAS: Epic, Arcadia, Innovaccer Earn Top Marks for Value-Based Care

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According to a new report from KLAS, payers and providers are looking to expand their value-based care contracts across business lines, and most are looking to do so with a fewer number of strategic...

Improper Payment Rate for Federally Facilitated Exchange Fell Under 1%

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The improper payment rate for the federally facilitated exchange (FFE) program was less than 1 percent in 2020, according to the annual 2022 Agency Financial Report from CMS and HHS. Improper payments...

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