Affordable Care Act

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...

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...

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...

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...

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...

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...

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...

The Affordable Care Act’s Effect on Hospital Charity Care

by Jacqueline DiChiara

Hospitals provide charity care according to patients’ income levels. But policies and patient criteria often vary depending on the particular hospital. Supporting hospital charity care while...

Affordable Care Act Saved Medicare Beneficiaries $20 Billion

by Jacqueline DiChiara

The Affordable Care Act (ACA) has saved over 10 million Medicare beneficiaries upwards of $20 billion on prescription drugs over the past six years, according to new information from the Centers for...

CMS Says Alternative Payment Models Still Have a Way to Go

by Jacqueline DiChiara

Leading healthcare experts are speaking out about whether or not the healthcare industry is making progress in regard to alternative payment models. The healthcare industry is apparently on the right...

AHA: Stark Law Exception Advances Alternative Payment Models

by Jacqueline DiChiara

Congress should focus on improving federal fraud and abuse laws, said the American Hospital Association (AHA) to the Senate Finance and House Ways and Means Committee last week. The AHA advocated for an...

How the Affordable Care Act Refines Revenue Cycle Management

by Jacqueline DiChiara

The Affordable Care Act (ACA) provides many greater opportunity for healthcare providers to strengthen their revenue cycle operations. As a consumer-driven revenue cycle management is becoming the new...

Affordable Care Act Creates Tax-Funded Expenditure Majority

by Jacqueline DiChiara

Over 64 percent of healthcare spending is tied to tax-funded expenditures, according to new data from the American Journal of Public Health. This reported number apparently contradicts commonplace...

CMS Tackles Medicare Spending, Medicaid Financial Incentives

by Jacqueline DiChiara

Medicare and Medicaid spending demands closer alignment for healthcare providers to better manage costs, according to a new report from the Centers for Medicare & Medicaid...

CMS Final Rule Revises Medicaid Reimbursement, Drug Rebates

by Jacqueline DiChiara

Medicaid reimbursement improvements are underway, according to a final rule from the Centers for Medicare & Medicaid Services (CMS). The rule – CMS-2345-FC – provides greater detail about...

CMS Makes Revisions to Medicare Prospective Payment System

by Jacqueline DiChiara

The Centers for Medicare and Medicaid Services (CMS) is making changes to the Medicare hospital inpatient prospective payment systems (IPPS). CMS says it is modifying 2016’s IPPS Pricer to...

Why Chronic Illness is Threatening the Healthcare Industry

by Jacqueline DiChiara

1 in 4 primary care physicians feel dangerously ill-equipped to successfully handle and coordinate care for some of their most challenging patients, such as those with chronic conditions, severe...

CMS, AMA Outline Evolving Healthcare Market Opportunities

by Jacqueline DiChiara

The Centers for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) discussed the evolving healthcare market yesterday at the J.P. Morgan Healthcare Conference in San...

How to Bend Healthcare’s Cost Curve Over the Next Decade

by Jacqueline DiChiara

Healthcare costs are growing but not as quickly as they once were. The big question is why? It’s a tough one to answer. To put it lightly, the delicate art of pinpointing specific or...

CMS Tackles Value-Based Purchasing Pilot Program Questions

by Jacqueline DiChiara

Competition across the nation for value-based payment incentives is underway with the start of a new year. Nine states, each representing a different geographic region, have implemented the...