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

Revenue Cycle Management Healthcare News

Medicare Bundled Payments Model Cut Costs, Maintained Quality

by

Payments declined for approximately three-quarters of the clinical episode combinations in the Medicare Bundled Payments for Care Improvement (BPCI) model without impacting care quality, CMS recently reported. Of the 67 BPCI model,...

Steady, Moderate Growth for Healthcare Prices and Spending in 2018

by

Healthcare prices and spending are seeing steady, but moderate growth, the Altarum Center for Value in Health Care recently reported. Healthcare prices increased just two percent in the second quarter of 2018, bringing healthcare price...

GAO Finds Uptick in Rural Hospital Closures as Inpatient Use Falls

by

Sixty-four rural hospitals closed between 2013 and 2017, more than double the number of rural hospitals closures in the prior five-year period, the Government Accountability Office (GAO) recently reported. Rural hospital closures are not...

200 Hospitals Face 5.5% Medicare Payment Cut Under Site-Neutral Rule

by

About six percent of hospitals subject to the Medicare Outpatient Prospective Payment System (OPPS) would be disproportionately impacted by a recent proposal to expand site-neutral Medicare payments, a new analysis shows. The 200...

3 Strategies to Minimize the Burden of Prior Authorizations

by

Prior authorizations, or prior approvals, are strategies that payers use to control costs and ensure their members only receive medically necessary care. The cost-control process requires providers to acquire advance approval from payers...

Implementing a Patient-Focused Culture Good Business for Practices

by

Fostering a patient-focused culture was a top business strategy top-performing medical groups and practices implemented in 2018, the Medical Group Management Association (MGMA) recently reported. As part of its 2018 MGMA DataDive Better...

Care Variation Reduction Key to Improving Care Quality, Costs

by

Higher care quality and care variation reduction result in lower healthcare costs, according to a new Advisory Board analysis. Analyzing healthcare cost and quality data from 468 hospitals from April 2014 to March 2017, the...

Exploring Virtual Groups in the Quality Payment Program, MIPS

by

Virtual groups enable independent physicians and clinicians in small practices to participate in Medicare’s historic push to transition to value-based reimbursement: the Quality Payment Program. The Quality Payment Program, or QPP,...

Quality Payment Program Top Regulatory Burden for Practices

by

For the second year in a row, medical practice leaders said the Quality Payment Program was their top regulatory burden in 2018. Eighty-percent of the 426 group practice leaders recently surveyed by the Medical Group Management...

Real Costs Up to 8% Higher for Some Cancers in Oncology Care Model

by

New research shows actual episode costs for certain cancers covered by Medicare’s Oncology Care Model differed by as much as eight percent, on average, from the predicted costs per episode. The Oncology Care Model (OCM) is a...

Medicare DSH Payment Case Makes Its Way to the Supreme Court

by

The Supreme Court recently agreed to review an appeal on a case that could affect up to $4 billion in Medicare Disproportionate Share Hospital (DSH) payments. Supreme Court judges approved a request from HHS to revisit an appellate...

Baylor Scott & White, Memorial Hermann Eye Hospital Merger Deal

by

Two major non-profit health systems in Texas recently announced their plans for a hospital merger, which is expected to advance cost-effective patient care in the state. Baylor Scott & White Health, a non-profit based in Dallas,...

Aligning Incentives for Providers, Payers Improves Primary Care

by

How the healthcare industry delivers and pays for primary care is changing as the country finds their healthcare spending skyrocketing. Healthcare spending across the country is slated to increase at an average annual rate of 5.5 percent...

CMS Clarifies Healthcare Price Transparency Rules for Hospitals

by

CMS recently expanded on new healthcare price transparency requirements for hospitals in a series of frequently asked questions (FAQs) published on its website. The FAQs cover which hospitals are subject to the new requirements, the...

Auditors Recouped $214M in Medicare Improper Payments in 2016

by

Recovery Audit Contractors (RACs) returned significantly more Medicare improper payments to the program’s trust fund during the 2016 fiscal year (FY), a recent CMS report to Congress shows. In FY 2016, the Medicare auditors returned...

Medicare Advantage Plans Overturn 75% of Their Own Claim Denials

by

A new report from the HHS Office of the Inspector General (OIG) reveals “widespread and persistent problems” related to prior authorization and claim denials in Medicare Advantage. Using Medicare Advantage data on denials,...

Clinical Documentation Improvement Solutions Up Provider Revenue

by

Provider organizations are seeing financial improvements after implementing clinical documentation improvement (CDI) solutions, a recent KLAS survey shows. Revenue improved for about 53 percent of healthcare executives, medical records...

AHA Decries Proposed Expansion of Outpatient Site-Neutral Payments

by

CMS should withdraw new proposals to expand site-neutral payments to hospital outpatient clinic visits and services from expanded clinical families delivered at off-campus provider-based departments (PBDs), the American Hospital...

CMS Finds Errors in 2019 MIPS Payment Adjustment Calculations

by

CMS recently announced that it is extending the targeted review deadline for 2017 Merit-Based Incentive Payment System (MIPS) performance feedback after the federal agency identified three errors with the scoring logic for the 2019 payment...

AMA, AHIP, and Others Oppose Upside-Only ACO Changes for MSSP

by

The American Medical Association (AMA), Medical Group Management Association (MGMA), and Health Care Transformation Task Force (HCTTF) are among nine industry groups calling on CMS to reconsider proposed changes to the Medicare Shared...

X

Join 30,000 of your peers and get free access to all webcasts and exclusive content

Sign up for our free newsletter:

Our privacy policy


no, thanks

Continue to site...