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

Affordable Care Act

Providers Need Time, Resources for MACRA Implementation

by Catherine Sampson

Driven by the Affordable Care Act, the implementation of Medicare Access and CHIP Reauthorization Act (MACRA) is expected to significantly impact the nation's healthcare system. Already, many physicians and various types of healthcare...

Despite ACA, Emergency Department Visits Remain Numerous

by Catherine Sampson

Although policymakers want to see the Affordable Care Act (ACA) lead to a reduction in visits to emergency departments, new data from the Centers for Disease Control & Prevention (CDC) raise concerns about the mandate’s real impact...

States Could Build Upon the Affordable Care Act to Cut Costs

by Vera Gruessner

The Affordable Care Act has had two main goals for the healthcare system: Increase health insurance coverage for Americans and lower healthcare spending around the country. At this point in time, the Affordable Care Act has brought health coverage...

How to Reduce Wasteful Spending in the Medicare Program

by Vera Gruessner

When the Affordable Care Act was passed several years ago, it had major implications for the future of the Medicare program. According to a study from the Private Enterprise Research Center at Texas A&M University, the Affordable Care Act...

CMS May Save $343 Million through Surgical Bundled Payments

by Vera Gruessner

The Centers for Medicare & Medicaid Services (CMS) launched the Comprehensive Care for Joint Replacement Model a little more than a week ago. This program is meant to issue bundled payments for a particular episode of care - in this case,...

Does Medicaid Expansion Improve Revenue of Hospitals?

by Vera Gruessner

The Affordable Care Act and Medicaid expansion has had a significant impact on hospitals around the country since full coverage for millions of Americans would lead to greater utilization of healthcare services and possibly strain the resources...

Affordable Care Act Increases Spending For Newly Insured

by Catherine Sampson

As the Affordable Care Act (ACA) brings more patients into the healthcare system, spending is on the rise, especially on chronic diseases, such as diabetes, heart disease and depression. Blue Cross Blue Shield (BCBS) backs this point in a recent...

Medicare Spending Increases Slightly under Affordable Care Act

by Jacqueline Belliveau

In 2014, Medicare spending for personal healthcare expenditures only increased by 2.4 percent per person and decreased by 3.6 percent for Medicaid, a recent report by the Department of Health and Human Services (HHS) stated. In comparison, overall...

Health Insurance Exchange Tips for Taxpayers Before April 15

by Vera Gruessner

With the deadline for filing this year’s taxes just around the corner, it is useful for insurance consumers to refresh the requirements of tax filing when covered through the health insurance exchange. The majority of people who purchase...

House Budget Proposes ACA Repeal, Reduced Medicare Spending

by Jacqueline Belliveau

The House of Representatives proposed budget plan for 2017 from the House Budget Committee aims to repeal the Affordable Care Act (ACA), reduce Medicare spending, and give states more control with health programs. “With respect to health...

CMS Releases 2016 Results for Value-Based Care Program

by Jacqueline Belliveau

The Center for Medicare and Medicaid Services (CMS) released the results for calculating the 2016 Value Modifier, which will come as financial boost to some and hindrance to others. Out of the 8,395 eligible physician groups, which satisfactorily...

9.4 Million Fewer Americans Struggle to Pay Medical Bills

by Vera Gruessner

Several years after the implementation of the Patient Protection and Affordable Care Act, the results seem to be showing that fewer Americans are struggling with paying medical bills and more than ever before have gained health insurance coverage....

Providers Squeezed to Integrate Care Management Solutions

by Vera Gruessner

At this year’s HIMSS conference and exhibition, Chilmark Research released the 2016 Care Management Market Trends report, which outlines how the market is leaning on healthcare providers to create care management solutions. The report also...

Examining the Value-Based Alternative Payment Model Basics

by Jacqueline DiChiara

Alternative payment models like the accountable care organization (ACO) and the bundled payment model have been gaining popularity under the Affordable Care Act’s (ACA) mandates. Figuring out how alternative payment models will evolve under...

CMS Provider Data Combats Medicare, Medicaid, CHIP Fraud

by Jacqueline DiChiara

To help combat healthcare fraud, the Centers for Medicare & Medicaid Services (CMS) has released a new pair of public data sets to promote greater Medicare and Medicaid data transparency and cut down on Medicare and Medicaid fraud,...

Price Transparency Still Missing from Hospital Revenue Cycle

by Jacqueline DiChiara

The Affordable Care Act’s (ACA) numerous price transparency provisions are inefficient, says a policy brief from the Pioneer Institute. Hospital executives must make consumer-friendly pricing information a top revenue cycle focus or else...

2 Medicare Alternative Payment Models Demanding Future Focus

by Jacqueline DiChiara

Medicare alternative payment models have the ability to make affordable, high quality care a reality. But providers still demand greater levels of care coordination and cleaner streamlining of clinical data to achieve value-based reimbursement...

Shared-Decision Making Advances Value-Based Care Outcomes

by Jacqueline DiChiara

Shared-decision making promotes strong dialogue between healthcare providers and healthcare consumers and builds stronger value-based care outcomes. At its core, shared-decision making gives beneficiaries more choice about their care and treatment...

CMS Rule Addresses Medicare Fraud, Overpayment Compliance

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) published a final rule this week focused on improving Medicare compliance, reporting, and self-identified overpayments to ultimately combat Medicare fraud. Under...

How Do High-Deductible Plans Affect Value-Based Care Goals?

by Jacqueline DiChiara

Value-based care outcomes are shaped by a variety of factors – but especially the ever influential high-deductible health plan (HDHP). The recent significant increase of HDHPs across the healthcare industry is apparently tied to their...

Continue to site...