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

Affordable Care Act

How can CMS Reform the Medicare Hospice Payment System?

by Stephanie Reardon

CMS must update the Medicare hospice payment system using the data gathered by this audit in order to meet the ACA requirements. The Department of Health and Human Service (HHS) Office of Inspector General (OIG) released the results of its audit...

Healthcare Leaders Express Confidence for 2015

by Ryan Mcaskill

A new study found that 68 percent of senior healthcare executives are predicting a stronger year ahead. Every healthcare provider keeps a close eye on Washington. With the industry evolving quickly thanks to the latest technology and changing...

Impact of Healthcare Subsidies Case Could be Substantial

by Ryan Mcaskill

According to new reports, King v Burwell could have a major impact on healthcare, depending on the ruling. Many experts have stated that the outcome of U.S. Supreme Court case King v Burwell will have a major impact on the healthcare industry....

How Can the Affordable Care Act Improve on Women’s Healthcare?

by Stephanie Reardon

Women are most impacted by unmet health needs due to financial burdens, in spite of the ongoing effort by physicians to lower healthcare costs. Despite new provisions of the Affordable Care Act (ACA), women are 24.4 percent  more likely than...

Increase in Preventive Care Improves Health, Lowers Cost

by Ryan Mcaskill

Since the Affordable Care Act was implemented, there has been an increase in preventive care visit from patients. One of the biggest pushes of the Affordable Care Act and other healthcare reform initiatives is increasing the focus on the value...

What Happens When Medicaid Expansion Goes Wrong?

by Stephanie Reardon

State officials terminated a $118.3-million contract with Hewlett-Packard for failure to implement a functional eligibility system to aid Medicaid expansion in New Jersey. As part of the launch of the Affordable Care Act (ACA),...

Medicare Payments Reduced for Hospital-Acquired Conditions

by Stephanie Reardon

721 hospitals will face a one-percent reduction in Medicare payments from the federal government. Despite incentives for hospitals to reduce hospital-acquired conditions (HACs), 721 hospitals will face a one-percent reduction in Medicare payments...

Legal Battle Over Affordable Care Act Subsidies Heats Up

by Ryan Mcaskill

King v. Burwell could affect the health insurance of millions in 37 states if the ACA is found at fault. The Affordable Care Act has been shackled with political and legal unrest since originally being proposed. A new battle is just gearing up...

Why is the Value-Based Care Adoption Rate Low?

by Ryan Mcaskill

A new AJMC study examined the challenges that physicians face when it comes to creating value-based care. One of the hottest trends in 2014 has been the increased focus on value-based care platforms instead of the fee-for-service approach. One...

HHS Announces $665 Million in ACA Healthcare Funding

by Ryan Mcaskill

The State Innovation Model initiative aims to help design and test new healthcare payment and service delivery model. The Department of Health and Human Services (HHS) is helping healthcare shift to solutions that improve quality, accessibility...

How Effective is the Medicaid Drug Rebate Program?

by Stephanie Reardon

Rebate program saved Medicaid an average of $15 billion annually. The Affordable Care Act (ACA) will soon be reducing Medicaid reimbursement. A recent survey was conducted by the Office of Inspector General (OIG) to test the effectiveness of...

HHS Distributes $36.3M in Affordable Care Act Funding

by Ryan Mcaskill

Health center quality improvements including EHRs, chronic disease management and preventive care focus of ACA funding. One of the goals of the Affordable Care Act and other forms of healthcare reform is to promote quality over quantity. There...

CMS Proposed Rule to Improve Payment Parameters for 2016

by Ryan Mcaskill

A new focus on transparency, accountability and the availability of information is created by a new CMS proposed rule. Healthcare payment provisions will be getting a new focus on affordability and accessibility with a proposed rule from the...

Hospital Sector Embraces Consolidation Over ‘Mega-Mergers’

by Ryan Mcaskill

A new study found ACO-style agreements are growing in 2014 instead of blockbuster mergers that were seen in 2013. Throughout 2013 in the hospital sector, a theme emerged known as the “mega-merger.” Several major health systems combined forces...

Accountable Care is Not a New Concept

by Ryan Mcaskill

The term Accountable Care Organization was coined in 2006 but the history of accountability in healthcare in much longer. One of the hottest trends in the healthcare landscape is accountability. Following the Affordable Care Act, a focus on value-based...

DSH system Could See Reduction in CMS Funding

by Ryan Mcaskill

The Affordable Care Act and congressional action could drop DSH funding by as much as $35.1 billion by 2024. Disproportionate Share Hospitals serve a significantly disproportionate number of low-income patients and receive payments from the Centers...

Patient Satisfaction Grows With Accountable Care Organizations

by Ryan Mcaskill

A new study found that beneficiaries are more satisfied with their care following a year with Accountable Care. One of the biggest changes to healthcare in the last few years, has been the growth of Accountable Care Organizations (ACOs). This...

2.3% Medical Device Tax Won’t Heavily Impact Healthcare Buyers

by Jennifer Bresnick

The controversial medical device tax will not significantly upset the market for manufacturers or healthcare organizations, a new report says. The 2.3% medical device tax rolled up into the Affordable Care Act will have some impact on prices...

Top Providers of Medicare Advantage, Drug Coverage Listed

by Ryan Mcaskill

With the Affordable Care Act’s open enrollment just around the corner, more consumer than ever before are looking to get coverage, some for the first time. Industry experts are advising individuals to comparison shop to make sure they get...

Consumer Activity Recommended for ACA Open Enrollment

by Ryan Mcaskill

Open enrollment for individual health care coverage under the Affordable Care Act for 2015 is a month away. Starting November 15,2014 and ending December 15, 2014, the second open-enrollment period will begin for those looking to sign up for...

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