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

Affordable Care Act

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 Medicare & Medicaid Services (CMS). Millions...

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 track thus far. Thirty percent of all Medicare...

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 exception to be created under the anti-kickback...

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 norm, the ACA plays an active role in healthcare’s...

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 perceptions about the cost of healthcare. Researchers...

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 Services (CMS). A CMS/state partnership Capitated...

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 Medicaid reimbursement and rebate calculation....

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 reflect a new payment calculation adjustment...

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 mental illness, and those in need of long-term...

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 Francisco, California. Their discussion was fittingly...

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 collective revenue cycle management causes poses...

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 home health value based purchasing pilot program...

3 Snags of Expensive Affordable Care Act Deductibles, Copays

by Jacqueline DiChiara

Money woes stemming from expensive Affordable Care Act (ACA) exchange policies may be hindering communication efforts between physicians and patients. Costly deductibles and copays mean patients may be more commonly skipping chats about drug...

CMS’s Quality Measurement Development Plan Supports MIPS, APM

by Jacqueline DiChiara

2016 may be an especially good year for healthcare providers when it comes to matters of revenue cycle management. The Centers for Medicare & Medicaid Services (CMS) recently posted a 63-page Measure Development Plan, a strategic framework...

10 Standout Revenue Cycle Management Quotes of 2015

by Jacqueline DiChiara

Actions speak louder than words. But sometimes, the pen is indeed mightier than the sword.  Here are 10 selected quotes (presented in no particular order), exclusive to RevCycleIntelligence.com from the last year that may make you stop...

CMS Shares New Qualified Entity Program Growth Developments

by Jacqueline DiChiara

It is an exciting time for healthcare, says the Centers for Medicare & Medicaid Services (CMS). Notable transparency developments are underway, wrote Niall Brennan, CMS Chief Data Officer and the Director of the Office of Enterprise...

Bipartisan Congressional Support for Cadillac Tax Growing

by Jacqueline DiChiara

Although the Cadillac Tax is not related to fast and furious cars, it is associated with widespread limitations on workplace health insurance. The United States Senate voted 90-10 earlier this month to approve an amendment fully repealing...

5 Claims Reimbursement Questions and Answers

by Jacqueline DiChiara

Money talks and the healthcare industry is listening. Claims reimbursement was one of many weighty revenue cycle management topics the healthcare industry kept an ear out for this year. From the art of claims scrubbing to figuring out how to...

Keeping an Eye on the Affordable Care Act: 2015 in Review

by Jacqueline DiChiara

The Affordable Care Act (ACA) has come a long way over the past 12 months. It is intended, as the name implies, to make health insurance more affordable and make sure more patients greater levels of overall coverage. Here is a 2015...

Why Successful Healthcare Executives Focus on Education

by Jacqueline DiChiara

The Affordable Care Act (ACA) aims to increase the number of people with health insurance by expanding Medicaid coverage nationwide. Are targets being hit or merely glossed over? Medicare Part D beneficiaries make up the bulk of the Medicare...

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