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

Affordable Care Act

ACA Support Rising to 55% as Physicians Value Quality Care

by Sara Heath

The Affordable Care Act (ACA) may be growing in popularity amongst healthcare professionals, according to a recent survey conducted by the American Association for Physician Leadership (AALP) and Navigant Center for Healthcare Research and Policy...

Is the ACA Working as Intended to Improve Healthcare Access?

by Jacqueline DiChiara

Is the Affordable Care Act (ACA) living up to its full potential or is it more a matter of all healthcare hands on deck? In past interviews with RevCycleIntelligence.com, healthcare experts and leaders from both athenahealth and the Robert...

4 Triumphs and Challenges in Medicare and Medicaid’s 50 Years

by Sara Heath

After 50 years as laws, Medicare and Medicaid have seen several triumphs and challenges, making their marks on American healthcare from expanding low-income coverage to raising serious questions about national finances.. As Medicare and Medicaid...

Will Medicare Part D Prescription Drug Plans Stabilize?

by Jacqueline DiChiara

As Medicare – established along with Medicaid on July 30, 1965 – formally hits its 5-decade anniversary this week, the healthcare industry turns over a new financial leaf upon considering where new spending and saving focuses...

NAMD Says Medicaid Managed Care Rule Restricts Healthcare Reform

by Sara Heath

In response to the proposed regulations of Medicaid managed care, the National Association of Medicaid Directors (NAMD) submitted a list of comments to the Centers for Medicare & Medicaid Services (CMS), according to a statement made by Matt...

‘Unjustified’ Premium Increases Obstruct ACA’s Transparency

by Jacqueline DiChiara

Covered California – which encompasses almost 13 percent of all Marketplace enrollees paying for nationwide coverage – announced yesterday a “modest” anticipated 4 percent statewide weighted average increase for 2016 healthcare...

Women’s Health Leader Shuns Senate’s Blocked ACA Repeal Vote

by Jacqueline DiChiara

The Affordable Care Act (ACA) is the most monumental breakthrough for women’s health within the last quarter century, according to a press release from Debra L. Ness, President of the National Partnership for Women & Families (NPWF)....

New Growth in Home and Community-Based Services Spending

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) has released its “milestone” 2013 Medicaid Expenditures for Long-Term Services and Supports Report. According to the Center for Medicaid and CHIP Services (CMCS), 2013 was the...

AK Gov. Proposes Sept. Medicaid Expansion Reform Under ACA

by Jacqueline DiChiara

Medicaid expansion may be the key to cutting state spending. The governor of Alaska, Bill Walker, recently notified a state committee that he plans to accept both federal and Mental Health Trust Fund Authority money to expand Medicaid to underprivileged...

Medicare Care Choices Model Awards Drive Choice, Quality

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) is focused on helping Medicare beneficiaries, their families, and loved ones acquire the right type of healthcare. This week, CMS announced the 141 urban and rural hospices selected...

Will CMS’s Star Ratings Improve Home Health Agencies’ Quality?

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) has published the first star ratings for Home Health Agencies on Medicare.gov. As the significance of a rating system is essential to the lives of many – from considering restaurant...

Fictitious Marketplace Enrollees Get Standardized Coverage

by Jacqueline DiChiara

The federal Health Insurance Marketplace (Marketplace) desperately needs to tighten up its security measures, confirms a new report from the US Government Accountability Office (GAO). In an undercover series of 18 tests to better identify how...

Value-Based Purchasing Model Revises Home Health Payments

by Jacqueline DiChiara

In an ongoing effort to advance the quality of economically profitable healthcare, the Centers for Medicare & Medicaid Services (CMS) looks again to the promotion of care quality. CMS’s new proposal launch, authorized through the Affordable...

CMS’s Fraud Prevention System Thwarts $820M in Payment Abuse

by Jacqueline DiChiara

A 10:1 return on taxpayer money is a rare feat. Nonetheless, an advanced state-of-the-art analytics system – the Fraud Prevention System – courtesy of The Centers of Medicare & Medicaid Services (CMS) is making such a goal tangible...

Risk-Value-Based Payment Programs a Return on Investment?

by Jacqueline DiChiara

Value-based payment readiness is apparently an area of weakness for senior financial executives, reports an executive survey from the Healthcare Financial Management Association (HFMA) and Humana. An analysis of return on investment (ROI), readiness...

Reconsidering ACA Limits, Fee-for-Value as Firm Payment Fix

by Jacqueline DiChiara

As the Affordable Care Act (ACA) continues to evolve, the healthcare industry thrives on crystal ball-esque predictions about what future challenges may arise. How will the Supreme Court’s King v. Burwell decision impact premiums and the...

Aetna Acquires Humana for $37B to Moderate Healthcare Costs

by Jacqueline DiChiara

Aetna has agreed to acquire its undersized competitor, Humana Inc, for $37 billion in cash and stock. The possible unifying together of two of the nation’s largest health insurers may generate an anticipated operating revenue this year...

What is the Future of Healthcare Mergers and Acquisitions?

by Jacqueline DiChiara

As healthcare mergers and acquisitions reach a record high, will financial consequences follow? The roles of critical access hospitals (CAHs) continue to change as more are closing their doors due to financial strain. There is solid debate among...

CMS Announces HPID Final Rule Public Commentary Period

by Jacqueline DiChiara

The Department of Health and Human Services (HHS) released a Request for Information (RFI) earlier this month on the Health Plan Identifier (HPID). HPID – a standard identifier for health plans – is required to be adopted under the...

Increased Deductibles Create More Revenue Cycle Challenges

by Jacqueline DiChiara

The ability to collect payment from patients has changed dramatically with the recent proliferation of high deductible health plans (HDHPs). Increased deductibles mean more revenue cycle challenges. There has been a significant increase within...

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