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

Healthcare Providers

Providers Who Accept Pharma Gifts Prescribe More Expensive Drugs

November 13, 2017 - Providers in the DC area who received gifts from the pharmaceutical industry tended to prescribe more drugs per patient, including more expensive, branded medications, than their peers who did not accept gifts, a recent PLoS One study showed. “Our study confirms and expands upon previous work showing that industry gifts are associated with more expensive prescriptions and more branded...


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Physician Advisors Crucial to Navigating Reimbursement Rules

by Jacqueline Belliveau

When physicians are asked why they went into medicine, the classic response is that they wanted to help people. But as value-based reimbursement takes hold and clinical documentation demands increase, providers are finding that the business of...

Low-Cost, Low-Value Resource Use Drives $586M in Wasteful Spending

by Jacqueline Belliveau

Inexpensive low-value resource use resulted in over $586 million, or $9.09 per beneficiary per month, in unnecessary healthcare spending in Virginia, a new Health Affairs study showed. The total amount spent on low-cost, low-value resource use...

CO’s Pediatric Care Network Brings Value-Based Care to Children

by Jacqueline Belliveau

Medicare has led the healthcare industry as it shifts from fee-for-service to value-based care, with 30 percent of traditional Medicare reimbursements already paid under an alternative payment model. The federal government plans to further transition...

Health Systems Responsible for 70% of Acute Care Hospitals

by Jacqueline Belliveau

New data from the Agency for Healthcare Research and Quality (AHRQ) showed that most hospitals were part of a health system in 2016. Almost 70 percent of non-federal generate acute care hospitals belonged to a health system, or network of at...

Payer Collaboration Key to Value-Based Reimbursement Strategy

by Jacqueline Belliveau

Value-based reimbursement arrangements come in a myriad of shapes and sizes much like provider organizations. But successful value-based contracts will align provider and payer goals for care quality and healthcare utilization as well as establish...

Surviving Solo with Independent Practice Association Support

by Jacqueline Belliveau

Healthcare reform and market forces are driving more independent practice leaders to consolidate with larger hospitals or health systems. But an independent practice association, like Vermont’s HealthFirst, can help solo providers leverage...

How Clinicians Add Value to Healthcare Supply Chain Management

by Jacqueline Belliveau

Engaging clinical staff is key to adding value to healthcare supply chain management, according to three supply chain leaders at MaineHealth, a recent ECRI Institute Healthcare Supply Chain Achievement award recipient. The healthcare network...

Physician Alignment Drives Healthcare Revenue Cycle Progress

by Jacqueline Belliveau

Hospital and health system leaders frequently rank decreasing healthcare costs and increasing efficiency as their top concerns year-after-year. But many healthcare organizations have struggled to implement and sustain healthcare cost reduction...

House Reps Address Physician Shortage in Medicare Residency Bill

by Jacqueline Belliveau

House representatives Joseph Crowley (D-NY) and Ryan Costello (R-PA) recently introduced legislation that aims to resolve physician shortage challenges by adding more Medicare-funded residency positions. A summary of the Resident Physician Shortage...

Physician Compensation for Specialists 45.6% More than for PCPs

by Jacqueline Belliveau

According to a recent Medscape survey, physician compensation for specialists was 45.6 percent more than what primary care providers earned in the past year. The survey of over 19,200 physicians in 27 specialists uncovered that the average physician...

AMGA President, CEO Donald W. Fisher, PhD, Passes at 71

by Jacqueline Belliveau

AMGA President and CEO, Donald W. Fisher, PhD, CAE, passed earlier this week after battling cancer, the healthcare industry group reported. Fisher, who was 71 years old, had led the organization since 1980. “Don leaves a professional and...

GAO: Quality Measure Misalignment Impedes Provider Improvement

by Jacqueline Belliveau

Healthcare quality measures are integral to determining value-based reimbursement, but misalignment of quality measures across public and private payers has made it more difficult for providers to develop quality improvements for value-based...

Physician Shortages Drive Increases in Provider Compensation

by Jacqueline Belliveau

The nationwide physician shortage continues to put pressure on healthcare organizations to retain quality employees by boosting employee compensation and providing incentives to stay at the organization, according to Health eCareers annual salary...

Healthcare Employment Increases Challenge Provider Orgs

by Jacqueline Belliveau

Despite significant increases in healthcare employment rates this year, employers and providers are still facing many challenges when it comes to delivering high quality care, such as physician burnout and rising turnover rates. A recent report...

Hospitals Face Healthcare Employment Challenges, High Turnover

by Jacqueline Belliveau

Recent healthcare employment trends could spell trouble for hospital revenue cycles across the nation. As quality and volume pressures continue to create difficult operational circumstances, some hospitals are finding that increasing turnover...

Driven by Specialists, Physician Compensation Rates Rise 3.1%

by Jacqueline Belliveau

Physician compensation has increased by 3.1 percent in 2015, according to a recent survey from the American Medical Group Association (AMGA). The rate represents a 0.3 percent increase from last year. “Once again this year, we see that...

FTC: Hospital Mergers and Acquisitions May Create Monopolies

by Catherine Sampson

Antitrust laws that prevent the formation of healthcare monopolies due to large-scale hospital mergers and acquisitions must be enforced in order to prevent skyrocketing healthcare costs, said Federal Trade Commission Chair Edith Ramirez at a...

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...

Five Best Practices to Prepare for Value-Based Reimbursement

by Catherine Sampson

Accountable care organizations (ACO) hold the key to successfully implementing value-based care and receiving value-based reimbursement. However, delivering quality care while also preparing for value-based reimbursement is not a simple task....

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