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

Revenue Cycle Management Healthcare News

Oncologists Need Data Reporting, Time for MACRA Implementation

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Although MACRA launched the Quality Payment Program on Jan. 1, 2017, a recent American Society of Clinical Oncology (ASCO) report stated that many oncology practices still need to expand or improve services and data reporting to meet the program’s...

Healthcare Supply Chain Issues Cause VA Center Director Change

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The VA recently removed its medical center director from his position and temporarily reassigned him to administrative duties after the Office of Inspector General (OIG) reported several patient safety concerns stemming from healthcare supply...

CMS Suggests Hospital Medicare Reimbursement Policy Changes

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CMS recently suggested changes to Medicare reimbursement policies for hospital admissions and long-term care hospital stays as well as several recommendations for other Medicare value-based purchasing programs. The proposed rule released on April...

Senators Push Bill to Address Physician Shortage in Rural Areas

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Three senators recently introduced a rural healthcare bill that would extend the Conrad State 30 Program until 2021 to help alleviate the physician shortage in designated Health Professions Shortage Areas or Medically Underserved Areas. Senators...

TN Law Aims to Make Payer Contract Management More Predictable

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Earlier this week, Tennessee Governor Bill Haslam signed the Provider Stability Act into law, which intends to increase transparency and accountability for payer contract management. Effective Jan. 1, 2019, the law will require payers in the...

Keep Medicare Bundled Payment Models Mandatory, Experts Say

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Switching Medicare bundled payment models that are currently mandatory in select regions to voluntary across the country would impede value-based reimbursement progress through episodic payment, industry experts warned the Trump administration...

28% of Adults Say Docs Discuss Patient Financial Responsibility

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Patients are still trying to figure out and compare healthcare prices, a recent Public Agenda survey showed. Yet only about 28 percent of the over 2,000 adults Americans surveyed said that their provider or their staff have discussed patient...

AHA: Uncompensated Care Costs Worksheet Inaccurate, Inconsistent

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The American Hospital Association (AHA) recently called on CMS to audit and modify the hospital cost report, Worksheet S-10, before the federal agency uses the report to determine each hospital’s uncompensated care costs and supplemental...

Hospital Execs Focus on Outpatient Growth, Healthcare Costs

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At the top of hospital and health system priority lists for 2017 is expanding patient access to ambulatory or outpatient care settings, according to 183 C-suite executives recently surveyed by the Advisory Board. Ranking at number six in last...

Medicaid Expansion Linked to $5M Annual Hospital Revenue Boost

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Hospital revenue in Medicaid expansion states increased by $5 million annually per facility after states chose to extend Medicaid coverage to more individuals, a recent Robert Wood Johnson Foundation and Urban Institute report showed. The study...

Healthcare Mergers May Face New Federal Rules Under SMARTER Act

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In a 16 to 20 vote earlier this week, the House Judiciary Committee passed the Standard Merger and Acquisition Reviews Through Equal Rules Act (SMARTER Act), which could affect how federal antitrust agencies evaluate healthcare mergers and acquisitions....

32 Orgs to Cut Healthcare Costs, Use Under CMS Community Demo

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As part of the Accountable Health Communities Model, CMS recently selected 32 organizations to participate in two of the three program tracks that aim to lower healthcare costs and utilization by fostering clinical and community service provider...

Healthcare Consumerism Challenges Primary Care Business Models

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Primary care providers are facing significant and oftentimes conflicting challenges in response to two major healthcare trends: value-based purchasing implementation and the rise of healthcare consumerism, a recent Journal of Internal Medicine...

Physician Compensation for Specialists 45.6% More than for PCPs

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According to a recent Medscape survey, physician compensation for specialists was 45.6 percent more than what primary care providers earned in the past year. The survey of over 19,200 physicians in 27 specialists uncovered that the average physician...

Healthcare Costs Rise With Regional Post-Acute Care Variations

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Despite receiving similar post-acute care services overall, rural hospital patients tend to undergo more skilled nursing facility treatment than home health care versus urban hospital patients, contributing to higher healthcare costs, according...

CMS Pauses Home Health Pre-Claim Review Demonstration

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CMS recently halted the home health Pre-Claim Review demonstration in Illinois for 30 days and the program will not expand to Florida as expected in April 2017, according to the federal agency’s website. “After March 31, 2017, and...

AMGA Supports 15% Limit for Medicare Advantage Encounter Data

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AMGA recently applauded CMS for further reducing the percentage of encounter data to be used to determine Medicare Advantage enrollee risk scores from 25 percent in the proposed rule to 15 percent in the final 2018 performance year update. “It...

MIPS Reporting Success Depends on Choosing Suitable Measures

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For Merit-Based Incentive Payment System (MIPS) reporting success, eligible clinicians should report on quality measures that they know their practice already performs well on, advised Michael Abrams, MA, a managing partner at the healthcare...

AHA: Post-Acute Care Medicare Reimbursement Reform Needs Time

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Later this month, the Medicare Payment Advisory Commission (MedPAC) plans to vote on a draft recommendation to Congress that would accelerate the development and implementation of a unified Medicare reimbursement system for four post-acute care...

Lean Primary Care Improves Physician Productivity, Costs

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A recent American Journal of Managed Care study showed that implementing a Lean primary care model resulted in operational cost reductions, physician productivity improvements, and higher patient satisfaction scores. “Our findings indicate...

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