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

Affordable Care Act

Medicaid Reimbursement Woes Key Concern for Healthcare CEOs

August 2, 2017 - Approximately 85 percent of healthcare executives identified shrinking Medicaid reimbursement rates and funding as a top concern in 2017, according to a new Deloitte survey. Deloitte surveyed 20 CEOs from health systems that collectively produced about $58 billion in operating revenue in 2014, with all but four systems reporting over $1 billion in annual operating revenue. The health system...

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CMS Details $43B Drop in Medicaid Uncompensated Care Support

by Jacqueline Belliveau

In a recently proposed rule, CMS outlined a methodology for reducing Medicaid support for hospitals incurring significant uncompensated care costs starting in 2018. The rule would implement reductions of $1 billion per year in Medicaid Disproportionate...

Pediatric Healthcare Costs 35% Less at Community Health Centers

by Jacqueline Belliveau

Pediatric healthcare costs were $1,133 on average among children primarily using community health centers for care versus $1,750 among children seeing other providers, representing a 35 percent difference, a recent Geiger Gibson/RCHN Community...

Execs To Continue Value-Based Purchasing Despite Uncertainty

by Jacqueline Belliveau

Despite a possible Affordable Care Act repeal, healthcare executives still plan to stay the course with value-based purchasing implementation and healthcare cost reduction initiatives, a recent BDC Advisors survey reported. Although the C-suite...

Senate Confirms Seema Verma as Next CMS Administrator

by Jacqueline Belliveau

In a 55 to 43 vote yesterday, the Senate confirmed Seema Verma as the next CMS Administrator, according to a New York Times article. Verma, the founder, president, and CEO of a health policy consulting firm, will be charged with managing...

52-47 Senate Vote Confirms Tom Price as New HHS Secretary

by Jacqueline Belliveau

Early this morning, the Senate approved Tom Price as the new Department of Health and Human Services (HHS) Secretary by a 52 to 47 vote, according to multiple sources. Price, a Republican representative from Georgia, will be the first provider...

Healthcare Execs Ponder Financial Impact of Possible ACA Repeal

by Jacqueline Belliveau

With a possible full or partial Affordable Care Act repeal in the near future, healthcare executives called for some of the healthcare reform law’s provisions to continue, such as increased insurance coverage and the value-based reimbursement...

Hospitals, Health Systems Eye Financial Snags in ACA Repeal

by Kyle Murphy, PhD

In identical letters to the Trump Administration and Congress, the American Hospital Association and other state and regional associations are urging members of both branches of the federal government to continue working on legislation to...

Executive Order Calls for ACA Financial, Marketplace Flexibility

by Jacqueline Belliveau

Just hours after taking office, President Trump signed a broad executive order that intends to minimize the “economic burden of the Patient Protection and Affordable Care Act” before an official repeal of the law. Under the executive...

AHA, FAH: ACA Repeal Could Cost Hospital Revenue Cycle Billions

by Jacqueline Belliveau

Providers could face billions in hospital revenue cycle losses if the Affordable Care Act is repealed without replacement legislation that preserves health coverage increases and rolls back claims reimbursement cuts, stated the American Hospital...

Slavitt Offers Value-Based Care Steps Post MACRA Implementation

by Jacqueline Belliveau

As CMS gets ready for MACRA implementation in the new year, CMS Acting Administrator Andy Slavitt urged healthcare and political leaders to carry on value-based care progress made under the Affordable Care Act. In a statement at the MACRA MIPS/APM...

Health Centers Face Post-ACA Revenue Cycle Management Issues

by Jacqueline Belliveau

Although the Affordable Care Act provided temporary funding to federally qualified health centers, a new study from the UCLA Center for Health Policy Research showed that community health centers will still need funding to resolve healthcare...

CBO: Future Hospital Profitability Requires More Productivity

by Jacqueline Belliveau

To stabilize hospital profitability at a six-percent average profit margin by 2025, providers must increase hospital productivity to offset Affordable Care Act provisions to decrease federal reimbursement rates and implement value-based penalties,...

How the Affordable Care Act Impacted Healthcare Revenue Cycle

by Jacqueline Belliveau

From the transition to value-based care to the rise in patient consumerism, the Affordable Care Act has significantly changed the healthcare revenue cycle management landscape since its passage in 2010. Healthcare providers restructured how they...

Hospital Profitability Rises by 35% in Oregon After ACA Passage

by Jacqueline Belliveau

Hospital profitability has increased for healthcare organizations across Oregon since the passage of the Affordable Care Act (ACA) in 2010, which enabled more individuals to become insured, the Oregon Health Authority has found. The report revealed...

Providers Collect More Revenue Due to ACA Medicaid Expansion

by Catherine Sampson

In recent years, the Affordable Care Act (ACA) paved the way for significant Medicaid expansion. A recent study from the National Bureau of Economic Research found that Medicaid expansion resulted in financial benefits for low-income patients...

Rural Hospitals May Get Senate Help with Medicare Reimbursements

by Catherine Sampson

As the healthcare industry shifts from volume to value, hospitals are expected to provide quality care as many could also potentially face lower Medicare reimbursements. At the same time, many hospitals in rural and economically distressed areas...

Providers Need Time, Resources for MACRA Implementation

by Catherine Sampson

Driven by the Affordable Care Act, the implementation of Medicare Access and CHIP Reauthorization Act (MACRA) is expected to significantly impact the nation's healthcare system. Already, many physicians and various types of healthcare...

Despite ACA, Emergency Department Visits Remain Numerous

by Catherine Sampson

Although policymakers want to see the Affordable Care Act (ACA) lead to a reduction in visits to emergency departments, new data from the Centers for Disease Control & Prevention (CDC) raise concerns about the mandate’s real impact...

States Could Build Upon the Affordable Care Act to Cut Costs

by Vera Gruessner

The Affordable Care Act has had two main goals for the healthcare system: Increase health insurance coverage for Americans and lower healthcare spending around the country. At this point in time, the Affordable Care Act has brought health coverage...


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