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

Affordable Care Act

$200K in Funding for Mich. Medicaid Beneficiary Care Access

by Jacqueline DiChiara

On February 23, The Blue Cross Blue Shield of Michigan (BCBSM) Foundation and Blue Cross Blue Shield of Michigan announced $200,000 in a handful of grants for Medicaid Beneficiary care access. Grants will assist with funding for Michigan’s...

Looking Back on 50 Years of Medicare and Medicaid

by Stephanie Reardon

The Medicare and Medicaid system has evolved along with the healthcare industry. It was a warm day on July 30, 1965 in Washington, D.C. when President Lyndon B. Johnson signed the Social Security Amendments bill into law. This would establish...

Indiana Implements ACA Medicaid Expansion

by Stephanie Reardon

Starting February 1, 2015, eligible beneficiaries will have access to affordable high-quality healthcare coverage . Indiana has become the 28th state (including DC)  to expand its Medicaid program under the Affordable Care Act (ACA), according...

Medicare and Medicaid Cuts One of Many Revenue Problems

by Stephanie Reardon

Medicare and Medicaid pay less for services rendered than private insurance. The Medicaid “fee bump” instated by the Affordable Care Act (ACA) temporarily increased the reimbursement rates for doctors who accepted Medicaid patients....

Can Increased Medicaid Reimbursements Improve Appointment Availability?

by Stephanie Reardon

Study determined Medicaid appointment availability directly correlated to the size of the Medicaid reimbursement increase implemented by the ACA. The Affordable Care Act (ACA) allows many previously uninsured individuals to get affordable...

High Deductibles Hurt Patient Pay Collections

by Stephanie Reardon

From 2003 to 2014, insurance premiums increased in every state in the country approximately three times more quickly than median household incomes. A brief published by the Commonwealth Fund, a foundation  aimed at improving the healthcare system,...

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...

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