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

Healthcare Payments

Limited Healthcare Payment Incentives Challenge Care Management

June 20, 2017 - Misaligned healthcare payment incentives topped the list of challenges providers and payers faced when implementing effective care management programs under Medicare Advantage plans with capitated payments, a recent Robert Graham Center for Policy Studies in Family Medicine and Primary Care report stated. “Absent coordination of incentives, care management programs often result in offices...

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AHA Calls For 25% Rule End for Fair LTCH Medicare Reimbursement

by Jacqueline Belliveau

The American Hospital Association (AHA) pressed CMS Administrator Seema Verma to reconsider proposed Medicare reimbursement provisions for long-term care hospitals (LTCHs). Specifically, the industry group called for a permanent end to the 25-Percent...

Top 4 Patient Financial Responsibility Collection Methods

by Jacqueline Belliveau

The top priority for providers is to deliver high-quality healthcare services to their patients. But the recent rise in patient financial responsibility and healthcare consumerism has forced some providers to bump patient collections to the top...

Payment Plans Tackle Hospital Patient Collection Challenges

by Jacqueline Belliveau

The growing popularity of high-deductible health plans has wedged many healthcare organizations between a rock and a hard place. Healthcare organizations are struggling to implement patient collection strategies that acquire all of a patient’s...

Execs Say Value-Based Purchasing to Hit Tipping Point by 2020

by Jacqueline Belliveau

Over one-half (55 percent) of healthcare executives surveyed after the recent presidential election stated that the industry should reach the value-based purchasing tipping point before 2020, a recent Lazard report revealed. The survey of 203...

Patient Financial Responsibility Not Owed Top Medical Debt Issue

by Jacqueline Belliveau

A recent report from the think tank Frontier Group and the US Public Interest Research Group (PIRG) Education Fund may spell trouble for providers attempting to collect overdue patient financial responsibility either internally or through a debt...

Credit Card On File Program Key To Patient Collections Success

by Jacqueline Belliveau

Implementing a credit card on file program boosted patient collections and reduced accounts receivable by 28 percent in six months at Orthopaedics & Rheumatology of the North Shore, a four-physician specialty practice in Illinois. Consumers...

28% of Adults Say Docs Discuss Patient Financial Responsibility

by Jacqueline Belliveau

Patients are still trying to figure out and compare healthcare prices, a recent Public Agenda survey showed. Yet only about 28 percent of the over 2,000 adults Americans surveyed said that their provider or their staff have discussed patient...

Preparing Providers for the Healthcare Consumerism Shift

by Jacqueline Belliveau

With a couple of swipes and clicks, patients are driving the shift to healthcare consumerism in the palm of their hands. But many healthcare organizations are not finding it as easy to align their care delivery and patient collection strategies...

Only 20% of Providers Offer Card-On-File Patient Collections

by Jacqueline Belliveau

Even though patient financial responsibility continues to grow, a recent Navicure survey showed that many healthcare organizations are not meeting patient collection needs, such as electronic payments. Th survey of providers and patients from...

4 Key Ways to Boost Point-of-Service Patient Collections

by Jacqueline Belliveau

In a time of healthcare consumerism and high-deductible health plans, the patient has become a major revenue source for healthcare organizations. But without strong point-of-service patient collection strategies, providers could be seeing their...

25% of Healthcare Payments Tied to Alternative Payment Models

by Jacqueline Belliveau

Only one-quarter of healthcare payments in 2016 will be connected to an alternative payment model that has population-based accountability, reported the Healthcare Payment Learning & Action Network (LAN). The survey of over 70 commercial,...

HHS Unveils Simpler Medical Billing Process Challenge Winners

by Jacqueline Belliveau

The Department of Health and Human Services (HHS) recently announced two winners of a medical billing competition that sought a simpler patient payment collections experience. The “A Bill You Can Understand” competition, sponsored...

WEDI Guide Suggests New Electronic Fund Transfer, ERA Standards

by Jacqueline Belliveau

The Workgroup for Electronic Data Interchange (WEDI) recently released a guide that advised all healthcare stakeholders to implement Automated Clearing House (ACH) Electronic Funds Transfers (EFT) and Electronic Remittance Advice (ERA) standards...

GAO: Weak Medicare, Medicaid Provider Screening Allows Fraud

by Catherine Sampson

The Centers for Medicare & Medicaid Services’ (CMS) provider enrollment screening process is vulnerable to fraud because many ineligible providers are still being entered into the Provider Enrollment, Chain and Ownership System (PECOS),...

Could More Competition Reduce Rising Prescription Drug Costs?

by Vera Gruessner

Prescription drug costs seem to be higher than ever before. Merrill Matthews, Resident Scholar at the Institute for Policy Innovation, wrote about some of the reasons behind these high prices and the solutions that could lower prescription drug...

Direct Physical Therapy Access Could Reduce Healthcare Costs

by Vera Gruessner

When it comes to healthcare costs, the federal government, medical providers, and payers are attempting to reduce rising spending and adopt value-based care reimbursement.  A number of different strategies have been implemented including...

Skilled Nursing Facility Payments Projected to Rise by $500M

by Jacqueline DiChiara

New policy changes further promote the Medicare payment transition from volume to value within the healthcare industry. The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule totaling 150 pages, CMS-1622-P, in mid-April regarding...

HHS Launches Health Care Payment Learning and Action Network

by Jacqueline DiChiara

The Department of Health and Human Services (HHS) Secretary Sylvia M. Burwell met with President Obama to launch the Health Care Payment Learning and Action Network. An estimated 2800 payers, providers, employers, patients, states, consumer groups,...


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