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

Healthcare Reform

How Healthcare Reform, Value-Based Care Define High-Performance

August 31, 2017 - Whether through the Triple Aim or Institute of Medicine’s six aims, healthcare reform efforts and value-based care models intend to transform health systems and hospitals into high-performing entities. But what exactly does it mean to be a high-performing healthcare organization, RAND Corporation researchers recently asked. Despite the focus on achieving high-performance, researchers...


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Orgs Offer Regulatory Relief to Boost Value-Based Purchasing

by Jacqueline Belliveau

In response to the recent CMS call for stakeholder feedback on how to provide regulatory relief, industry groups detailed ways to reduce red tape associated with value-based purchasing implementation. Hospitals and individual providers have recently...

Execs To Continue Value-Based Purchasing Despite Uncertainty

by Jacqueline Belliveau

Despite a possible Affordable Care Act repeal, healthcare executives still plan to stay the course with value-based purchasing implementation and healthcare cost reduction initiatives, a recent BDC Advisors survey reported. Although the C-suite...

MedPAC Targets Post-Acute Care for Healthcare Payment Reform

by Jacqueline Belliveau

In its March 2017 report to Congress, the Medicare Payment Advisory Commission (MedPAC) pinpointed post-acute care for healthcare payment reform after Congressional and CMS inaction resulted in as much as $11 billion in lost savings since 2009....

Senate Confirms Seema Verma as Next CMS Administrator

by Jacqueline Belliveau

In a 55 to 43 vote yesterday, the Senate confirmed Seema Verma as the next CMS Administrator, according to a New York Times article. Verma, the founder, president, and CEO of a health policy consulting firm, will be charged with managing...

AHA, FAH Oppose Proposed Physician Self-Referral Law Changes

by Jacqueline Belliveau

The American Hospital Association (AHA) and the Federation of American Hospitals (FAH) recently urged lawmakers to oppose a proposed bill that would extend physician self-referral allowances to physician-owned hospitals. In late February, House...

Executive Order Calls for ACA Financial, Marketplace Flexibility

by Jacqueline Belliveau

Just hours after taking office, President Trump signed a broad executive order that intends to minimize the “economic burden of the Patient Protection and Affordable Care Act” before an official repeal of the law. Under the executive...

Do Nurse Practitioners Increase Healthcare Spending Rates?

by Catherine Sampson

While the use of independent nurse practitioners (NPs) is often seen as an important way to drive down healthcare spending rates, a new report from researchers at the University of California San Francisco indicates that the positive...

For Truly Value-Based Care, Use Outcomes Instead of Processes

by Catherine Sampson

Value-based care is the goal of many of the nation’s healthcare reform efforts, yet basing regulatory changes and provider-facing metrics on checking off processes instead of achieving outcomes could be the wrong approach, states a new...

House Budget Proposes ACA Repeal, Reduced Medicare Spending

by Jacqueline Belliveau

The House of Representatives proposed budget plan for 2017 from the House Budget Committee aims to repeal the Affordable Care Act (ACA), reduce Medicare spending, and give states more control with health programs. “With respect to health...

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 maintaining tight margins is a challenge, especially...

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...

Why Flawed Alternative Payment Model Design Holds MACRA Back

by Jacqueline DiChiara

Alternative Payment Models (APMs) do not adequately address payment system problems, according to a new report from the Center for Healthcare Quality and Payment Reform (CHQPR). Healthcare payment reform is apparently progressing at a snail’s...

High Patient Experience Ratings Up Revenue Cycle Management

by Jacqueline DiChiara

Positive patient experience ratings generate a healthy and happy revenue cycle management, according to Press Ganey’s new white paper. But healthcare payment reform challenges may be keeping providers from seeing more revenue...

Why HOPD Medicare Expenditures Need Equalized Payment Rates

by Jacqueline DiChiara

Medicare expenditures for hospital outpatient departments (HOPD) services are apparently on the rise, especially in recent years. A new report to Congressional requesters from the United States Government Accountability Office (GAO) examines...

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...

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 Patient Advocacy is the New Future of Healthcare Reform

by Jacqueline DiChiara

There is power in numbers, especially when it comes to healthcare reform. A group of 9 major patient advocacy groups – AIDS United, American Liver Foundation, Amputee Coalition, the Christopher & Dana Reeve Foundation, Hemophilia Federation...

How to Sustainably Bend the Cadillac Tax Cost Curve

by Jacqueline DiChiara

The Cadillac of healthcare coverage is the talk of the healthcare industry as 2016 draws nearer. The United States Senate recently voted 90-10 to repeal the Cadillac Tax – a 40 percent excise tax and Affordable Care Act component...

Why Medicare Reform Means Maintaining Low Cost, Readmissions

by Jacqueline DiChiara

Medicare reform must boldly empower seniors to better control their healthcare spending, according to an October report from Devon M. Herrick, PhD, Senior Fellow at the National Center for Policy Analysis. Herrick presents a tri-fold...

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