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

Affordable Care Act

Independent Payment Advisory Board Threatens Medicare Costs

by Jacqueline DiChiara

There are new Medicare cost concerns within the healthcare industry. Hundreds of healthcare organizations are actively voicing concerns to Congress about financial threats to private sector consumers and a possible watering down of industry-wide...

$101M ACA Health Center Funding Increases Healthcare Access

by Jacqueline DiChiara

$101 million in Affordable Care Act funding will go toward the delivery of comprehensive primary health services at 164 new health center sites across 33 states. The objective of such funding – the New Access Point Grant Awards –...

Cost Inflation of Hospital Mergers, Physician Acquisitions

by Jacqueline DiChiara

In a recent letter addressed to The Wall Street Journal’s Editor from a group of healthcare leaders and experts, Rich Umbdenstock, President and CEO of the American Hospital Association (AHA), Brian Kent, MD, Robert W. Geist, MD, and Richard...

Skilled Nursing Facility Payments Projected to Rise by $500M

by Jacqueline DiChiara

New policy changes further promote the Medicare payment transition from volume to value within the healthcare industry. The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule totaling 150 pages, CMS-1622-P, in mid-April regarding...

Bundled Hospital Care Payments: Remodeling a Broken System

by Jacqueline DiChiara

The concept of bundled hospital care payments — a singular (bundled) payment generated from hospitals, physicians, and post-acute care providers for services rendered from a specific care episode — has been under close microscopic...

Will Hospital Ratings Promote Transparency or Blind Eyes?

by Jacqueline DiChiara

Choosing a hospital based on quality of care in relation to financial factors can be an arduous task. The Centers for Medicare & Medicaid Services (CMS) is simplifying this process through its new introduction of hospital star ratings announced...

Mechanized Claims Processing the Future of Medicaid?

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) present a proposed rule to extend enhanced federal financial participation for Medicaid eligibility and enrollment systems beyond the...

CMS’ Open Payments Advance Revenue Cycle Transparency

by Jacqueline DiChiara

Physicians and teaching hospitals across the healthcare spectrum will be buried in a numbers game come April 6, 2015 when The Centers for Medicare & Medicaid Services’ (CMS’) period of payment review for physicians begins. Open...

Does ACA Boost Physicians’ Medicaid Participation?

by Jacqueline DiChiara

Medicaid beneficiaries are keeping the doctor away. Newly released data may offer a fresh industry-wide perspective about how often physicians accept Medicaid regarding delayed implementation stemming from the Affordable Care Act’s (ACA’s)...

Medicaid Providers Struggling to Raise Reimbursement Rates

by Jacqueline DiChiara

Medicaid providers seeking to raise their reimbursement rates by suing the government are essentially out of luck, according to documentation within a recent Supreme Court ruling. “The notion that respondents have a right to sue,”...

Has the Affordable Care Act Led to a Slowdown in Premiums?

by Jacqueline DiChiara

Slow and steady appears to be the financial mantra echoing forth within the healthcare industry. There has been a distinct deceleration in premium growth within the past three years following the implementation of Affordable Care Act...

Will Cost Shifting Drive Support for Larger Public Payments?

by Jacqueline DiChiara

Speculation abounds around whether hospitals’ decisions to increase the prices charged to commercially insured individuals to compensate for decreased Medicare reimbursement via cost shifting will reduce the healthcare industry’s...

Why Is Medicaid Expansion a Win for Healthcare Providers?

by Jacqueline DiChiara

As anyone standing before a plate of freshly baked desserts or fearfully opening a credit card bill post online shopping binge can attest, the art of equilibrium is essential. This idea of balance is also needed within the financial realm of...

Quantify Denial Rates for Smooth Revenue Cycle Management

by Jacqueline DiChiara

A hospital or medical practice’s ability to swiftly and economically process claims and quantify denial rates is critical to ensure smooth revenue cycle management and medical reimbursement. The ability to accurately predict reimbursement...

HHS Launches Health Care Payment Learning and Action Network

by Jacqueline DiChiara

The Department of Health and Human Services (HHS) Secretary Sylvia M. Burwell met with President Obama to launch the Health Care Payment Learning and Action Network. An estimated 2800 payers, providers, employers, patients, states, consumer groups,...

Affordable Care Act Means Lower Reimbursement for Physicians

by Jacqueline DiChiara

One year after The Affordable Care Act’s (ACA) implementation, most physicians urge Congress to overturn the legislation after experiencing lower reimbursement, as reported in a recent physician survey. Although 44 percent of surveyed physicians...

Adapting the Healthcare Revenue Cycle to Changing Regulation

by Jacqueline DiChiara

Providers continue to evaluate healthcare revenue cycle and volume in relation to the Affordable Care Act (ACA). ACA’s underlying elements — Medicaid expansion and reform — are under close examination. Derek Bang, CPA, CGMA,...

The Difficulty in Quantifying Improper Medicaid Payments

by Jacqueline DiChiara

Recently, the Government Accountability Office (GAO) recommended that state Medicaid agencies should mandatorily quantify improper Medicaid payments and inform the effectiveness of their electronic payment-integrity tools to the federal...

Medicaid Acceptance, Payment Rates Both on the Decline

by Jacqueline DiChiara

The issue of a widespread lack of Medicaid acceptance is ongoing and yet to be resolved. A short-lived increase in Medicaid payments to primary care physicians last year has not generated an increase in Medicaid acceptance. More intervention...

King v. Burwell Opposition Means 9.3 Million Lose Subsidies

by Jacqueline DiChiara

The King v. Burwell case will be formerly addressed within the US Supreme Court on March 4, 2015. The Supreme Court will hear arguments regarding the Affordable Care Act’s (ACA) future implications and if the Internal Revenue Service will extend...

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...