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

Revenue Cycle Management Healthcare News

Looking Beyond Price in the Healthcare Supply Chain to Add Value

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Don’t equate value in the healthcare supply chain with just price, Premier, Inc’s Myla Maloney recently advised healthcare stakeholders at Xtelligent Healthcare Media’s Value-Based Care Summit in Boston. “Price...

Healthcare Prices Significantly Vary Across the US, HCCI Finds

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Healthcare prices not only significantly varied across metro areas, but also within metro areas, a new analysis from the Health Care Cost Institute (HCCI) showed. In its first report part of the Healthy Marketplace Index (HMI) project,...

OIG: Healthcare Fraud Exceptions for 2 Value-Based Payment Models

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Two recent advisory opinions from the Office of the Inspector General (OIG) at HHS are demonstrating why current healthcare fraud and abuse laws are not aligned with value-based payment and care delivery. The federal watchdog recently...

CMS to Help Medicaid Reimburse for Maternal Opioid Misuse Care

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CMS recently announced that it will be awarding up to $64.6 million to 12 state Medicaid agencies to help develop Medicaid reimbursement and care delivery strategies for maternal opioid misuse treatment. The awards are part of the new...

36% of ACOs Consider Quitting MSSP Under New Proposed Rules

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Over one-third of accountable care organizations (36 percent) said they are unlikely to continue with the Medicare Shared Savings Program (MSSP) if the proposed overhaul is finalized, a recent survey showed. Only 48 percent of ACO leaders...

Putting Both Feet in the Value-Based Care, Reimbursement Boat

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“Do not put each foot in a different boat,” warned Partners HealthCare CFO Peter Markell at Xtelligent Healthcare Media’s third annual Value-Based Care Summit in Boston. But the current reality in healthcare is that...

Healthcare Dollars Moving to Alternative Payment Models, LAN Finds

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Approximately 34 percent of all healthcare payments made in 2017 were tied to an alternative payment model (APM) with shared savings, shared risk, bundled payments, or population-based payments, according to a new report from the Health...

More Site-Neutral Payments to Impact Value-Based Care, Reps Says

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Over 130 members of the House of Representatives recently urged CMS to reconsider a proposed expansion of site-neutral payments to grandfathered off-campus provider-based hospital departments in 2019. The Oct. 18, 2018 letter to CMS...

HRSA Awards $293M to Bolster the Primary Care Workforce

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The Health Resources and Services Administration (HRSA) is looking to bolster primary care by awarding $293 million to expand the primary care workforce, HHS recently announced. The healthcare industry is facing a serious physician...

Medical Spending, Utilization the Same for Cancer Patients in ACOs

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Cancer patients treated by providers in a Medicare accountable care organization (ACO) did not see lower medical spending or healthcare utilization compared to similar patients treated at non-ACO practices, a new study in the Journal of...

Hospitals Lagging with Healthcare Cost Transformation Efforts

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Healthcare cost transformation is a top hospital and health system need. But less than one in five executives reported cost reductions of more than five percent in any priority area in the last year, a new Kaufman Hall survey...

Maximizing MIPS Scores Through Chronic Disease Prevention

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The healthcare industry is moving beyond a “sick care” system and shifting to chronic disease prevention to lower costs and improve quality. However, the healthcare payment system is just catching up to the preventative care...

Telemedicine at Center of Billion-Dollar Healthcare Fraud Scheme

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Law enforcement officials in Tennessee recently charged four individuals and seven companies involved in a $1 billion healthcare fraud scheme involving telemedicine services, according to details recently released by the Department of...

CMS to Extend Healthcare Price Transparency to Prescription Drugs

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CMS is attempting to extend healthcare price transparency to prescription drugs. According to a recently proposed rule, drug manufacturers may have to start including the list price for the medications they advertise on television. As...

Senator Urges FTC to Investigate Hospital Contracting Practices

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Senate Judiciary Committee Chairman Chuck Grassley (R-IA) recently called on the Federal Trade Commission (FTC) to investigate whether hospitals and payers in the US are deliberately engaging in anticompetitive hospital contracting...

4 Hospital Business Models for Consumer-Centric Healthcare

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When a member of Gurpreet Singh’s family broke his wrist, they didn’t go to a hospital emergency room or an academic medical. Instead, the family headed to an urgent care center to triage the situation and develop a care...

Hospital Readmission Program Penalties Didn’t Raise Mortality Rates

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The Hospital Readmission Reduction Program (HRRP) achieved a significant drop in readmission rates for Medicare patients hospitalized for pneumonia, acute myocardial infarction (AMI), and heart failure without bringing an increase of...

61% of Doctors Say Value-Based Care Will Damage Their Practice

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Physicians are still on the fence about the impact value-based care will have on their business and patient care, a recent survey showed. Forty-nine percent of over 3,400 physicians recently surveyed by the nation’s largest...

Healthcare Business Office Experience Impacts Patient Collections

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Consumers are less likely to pay their patient financial responsibility in full if they experience a negative healthcare business office interaction, a new survey shows. The survey of 500 recent healthcare consumers conducted by Connance...

Hospital Prices in Colorado Increase 76% As Expansions Continue

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Hospital prices in Colorado increased 76 percent over a seven-year period as profits rose to some of the highest in the nation, preliminary data from the state’s Department of Health Care Policy and Financing showed. Initial...

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