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

Affordable Care Act

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...

Subsidies Upheld, State-Run Exchanges Face Funding Issues

by Jacqueline DiChiara

The King v. Burwell ruling will likely be the last major hurdle the Affordable Care Act (ACA) faces from court challenges. Says Bill Melville, Market Analyst for Decision Resources Group, to RevCycleIntelligence.com, even if subsidies are upheld...

‘Affordable’ Affordable Care Act as Sustainable Cost Model

by Jacqueline DiChiara

King v. Burwell's aftermath has been both praised as a “positive” and “disastrous” ruling as the dust continues to clear following last Thursday’s decision from the Supreme Court. Ralph S. Tyler, Partner Venable...

Burwell Addresses King v. Burwell: ‘Seize This Opportunity’

by Jacqueline DiChiara

The Affordable Care Act (ACA) is simply part of the fabric of America, says Sylvia M. Burwell, Secretary of the Department of Health and Human Services (HHS), during a White House press call mere hours after the monumental King v. Burwell decision...

Considering King v. Burwell’s Construction, Interpretation

by Jacqueline DiChiara

The aftermath of King v. Burwell is spreading like wildfire across the healthcare industry. Opinions and reactions circulate rather heavily this week – including thoughts from Sylvia M. Burwell, Secretary of the Department of Health and...

HHS Secretary Burwell Speaks on ACA, King v. Burwell

by Jacqueline DiChiara

Today’s King v. Burwell decision from the Supreme Court to uphold subsidies is a groundbreaking moment for the healthcare industry.  King v. Burwell examines whether or not those federal premium subsidies issued to residents...

Supreme Court Upholds Subsidies in King v. Burwell Decision

by Jacqueline DiChiara

The Supreme Court has ruled on King v. Burwell, a stunningly significant healthcare lawsuit intended to formally unravel various foundational components of the Affordable Care Act (ACA). The ACA has been upheld, as the Supreme Court issued...

How does the ACA Impact Providers’ Trust of Payers?

by Jacqueline DiChiara

How are those healthcare payers participating in Affordable Care Act (ACA) implementation performing? Perhaps pretty well, according to a tenth annual PayerView report card and ninth annual Payer Trust Index released consecutively by athenahealth...

King v. Burwell Requires Addressing the Affordability Crisis

by Jacqueline DiChiara

The Supreme Court will soon rule on King v. Burwell, a momentous lawsuit intended to essentially reverse various pieces of the Affordable Care Act (ACA) with the possibility of subsidies for 6.4 million Americans coming to an end. Although a...

Is King v. Burwell a ‘Downward Death Spiral’ for Revenue?

by Jacqueline DiChiara

  King v. Burwell – a critical landmark lawsuit aimed to actively unravel core components of the Affordable Care Act (ACA) – is a heavily trending topic this week as the healthcare industry awaits the Supreme Court’s...

June 19: Week That Was in Healthcare Fraud and Malpractice

by Jacqueline DiChiara

Here is a general roundup of the past week’s developments in healthcare fraud and malpractice, as reported by the Department of Justice and the Office of Inspector General. The crimes reported below result in multiple millions of dollars...

CMS’s Internal Controls Neglect Payment Accuracy under ACA

by Jacqueline DiChiara

The internal controls that calculate and authorize financial assistance payments on behalf of the Centers for Medicare & Medicaid Services (CMS) are failing, says a report from the Office of the Inspector General (OIG)....

Will Inefficient Financial Healthcare Reform Kill the ACA?

by Jacqueline DiChiara

Is the Affordable Care Act (ACA) hurling the healthcare industry further into the red? The answer is a definite yes, according to a recent RevCycleIntelligence.com article about key findings from a pair of Harvard Medical...

Senate Finance Committee, NKF Address Medicare Spending

by Jacqueline DiChiara

The vast majority of Medicare dollars – 93 percent – accounts for chronic illness. As reported by RevCycleIntelligence.com, a recent legislative proposal from the Senate Finance Committee aims to dramatically improve care for rurally-based...

Is Consumer-Centric Revenue Cycle Management the Solution?

by Jacqueline DiChiara

Is revenue cycle management in need of a drastic overhaul? As the ever evolving landscape of the healthcare industry continuously adjusts its sails, revenue cycle management may be continuously falling backwards amidst antiquated winds. A...

ACA Adds Billions in Bureaucratic Waste, Administrative Costs

by Jacqueline DiChiara

The Affordable Care Act (ACA) will prove a tremendous financial burden to the healthcare industry. Although the administrative costs of healthcare are projected to remain high throughout 2022, the ACA only promotes billions of dollars...

CMS Proposed Rule Modernizes CHIP and Medicaid Managed Care

by Jacqueline DiChiara

Following a recent series of proposed physician fee schedules and payment rules from the Centers for Medicare & Medicaid Services (CMS), a new proposed rule, CMS-2390-P, aims to modernize Medicaid managed care policies to mirror changes within...

Do Reimbursement Limitations Deter Telemedicine Integration?

by Jacqueline DiChiara

Telemedicine and reimbursement do not always go hand in hand. Reimbursement complications often hinder telemedicine's progression within the healthcare industry, as RevCycleIntelligence.com reported. Nadia de la Houssaye,...

Spending Advances Medicaid with Transparency, Accountability

by Jacqueline DiChiara

The US Government Accountability Office (GAO) has released a report reviewing approved expenditure authorities within section 1115 of the Social Security Act. This segment of the Social Security Act allows the Secretary of the Department...

EHRs Advance Medicaid Reimbursement and Stabilize Insurance

by Jacqueline DiChiara

The meaty 1,024 pages of the Affordable Care Act (ACA) call for the vast expansion of healthcare coverage, the active promotion of decreased healthcare costs, and enhanced quality care. In the midst of ACA expansion efforts, Medicare and Medicaid...

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