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

Healthcare Costs

AMGA: Align Medicare Reimbursement, Measures for High-Value Care

by Jacqueline LaPointe

AMGA recently called on CMS to align quality measures with spending performance as well as Medicare reimbursement policies across Medicare Advantage, fee-for-service models, and accountable care organizations (ACOs). In two letters to CMS...

Hospitals Maintain Test Use Despite Healthcare Price Transparency

by Jacqueline LaPointe

Increasing healthcare price transparency for providers did not result in fewer laboratory tests ordered or lower healthcare costs, a recent JAMA Internal Medicine study found. “In this year-long randomized clinical trial conducted...

CMS Calls On Rural Hospitals to Join Alternative Payment Model

by Jacqueline LaPointe

CMS is seeking applicants to participate in a new round of the Rural Community Hospital Demonstration Program that tests a cost-based alternative payment model among small rural hospitals. Lawmakers authorized a five-year extension of the...

32 Orgs to Cut Healthcare Costs, Use Under CMS Community Demo

by Jacqueline LaPointe

As part of the Accountable Health Communities Model, CMS recently selected 32 organizations to participate in two of the three program tracks that aim to lower healthcare costs and utilization by fostering clinical and community service...

Healthcare Costs Rise With Regional Post-Acute Care Variations

by Jacqueline LaPointe

Despite receiving similar post-acute care services overall, rural hospital patients tend to undergo more skilled nursing facility treatment than home health care versus urban hospital patients, contributing to higher healthcare costs,...

Lean Primary Care Improves Physician Productivity, Costs

by Jacqueline LaPointe

A recent American Journal of Managed Care study showed that implementing a Lean primary care model resulted in operational cost reductions, physician productivity improvements, and higher patient satisfaction scores. “Our findings...

Is Radiation Overuse Contributing to Higher Healthcare Costs?

by Jacqueline LaPointe

Oncologists could have saved over $164 million in healthcare costs if they had adhered to clinical guidelines and prescribed shorter radiation treatment for some breast cancer patients, a recent Journal of Oncology Practice study...

Patient Collection Rates Drop as Out-of-Pocket Costs Go Up

by Jacqueline LaPointe

Hospitals collect significantly less from patients with higher out-of-pocket costs, a Crowe Horwath study confirmed. The study revealed that collection rates for patient accounts with balances greater than $5,000 were four times lower than...

NJ Quality Improvement Model Lowers Healthcare Costs by $641M

by Jacqueline LaPointe

Hospitals in New Jersey reduced healthcare costs by over $641 million between 2012 and 2016 after implementing a statewide quality improvement initiative, the New Jersey Hospital Association (NJHA) recently reported. Under the Affordable...

Out-of-Pocket Healthcare Spending Rose 65% at Freestanding EDs

by Jacqueline LaPointe

Freestanding emergency departments are becoming a popular alternative care setting for common conditions, such as upper respiratory infections. But a recent study in the Annals of Emergency Medicine found that median prices for...

Managing Healthcare Costs, Data Analytics Top C-Suite Priorities

by Jacqueline LaPointe

Under the Trump administration, the healthcare industry is bracing for some significant policy changes, such as a potential Affordable Care Act repeal. Despite the political change, healthcare executives still plan to make healthcare cost...

Healthcare Spending Varies More by Provider Than Hospital

by Jacqueline LaPointe

A recent JAMA Internal Medicine study uncovered that healthcare spending varied more across individual providers than across hospitals. Based on Medicare data on hospitalized beneficiaries from 2011 to 2014, researchers from several...

Diabetes Clinic Lowers Healthcare Costs More Than PCP Visits

by Jacqueline LaPointe

A California-based health system reduced healthcare costs by 2.5 percent more for diabetes patients by implementing a clinic that brings endocrinologists and pharmacists together to better manage medically complex diabetic patients, a...

Health IT, Care Navigators Most Effective at Lowering Costs

by Jacqueline LaPointe

While countless strategies are out there for making care delivery more efficient, a recent Health Affairs study revealed that interventions that use health IT and community health workers realized the greatest cost savings. Researchers...

Higher Hospital Costs Stem from ICU Overuse for Some Conditions

by Jacqueline LaPointe

Healthcare providers may be able to decrease hospital costs by avoiding ICU admissions for some patients with chronic obstructive pulmonary disease (COPD), exacerbation of heart failure (HF), and acute myocardial infarction (AMI), a recent...

Transradial, Same Day Discharge Cardiac Care Drops Costs by $3.7K

by Jacqueline LaPointe

From acute myocardial infarctions to coronary artery bypass grafts initiatives, recent Medicare bundled payment models have providers focusing more on reducing healthcare costs and improving care quality for a range of cardiac care...

Understanding 2017 MIPS Quality, Cost Performance Categories

by Jacqueline LaPointe

CMS leaders at HIMSS17 were not shy with telling session attendees that they are currently in the first Quality Payment Program performance year. To help providers better understand the program, which launched on Jan. 1, the federal...

78% of Hospital Staff Still Face Manual Supply Chain Management

by Jacqueline LaPointe

Hospitals may not be operating with the most efficient healthcare supply chain management tools, a recent Cardinal Health and SERMO survey found. Only 17 percent of hospital staff reported that their facility installed an automated...

FFS, Risk-Based Medicaid ACO Programs Similarly Reduce Costs

by Jacqueline LaPointe

In a comparison of two state Medicaid Accountable Care Organization (ACO) programs, researchers in a JAMA Internal Medicine study found that Oregon’s global capitation ACO model produced similar healthcare savings and care quality...

Asthma Education Model Lowers Resource Use, Healthcare Costs

by Jacqueline LaPointe

Asthma education programs can help providers to significantly reduce unnecessary resource use and healthcare costs by boosting patient knowledge about chronic disease management, a recent American Journal of Managed Care study...

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