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

Healthcare Revenue Cycle

28% of Adults Say Docs Discuss Patient Financial Responsibility

by Jacqueline LaPointe

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...

Healthcare Mergers May Face New Federal Rules Under SMARTER Act

by Jacqueline LaPointe

In a 16 to 20 vote earlier this week, the House Judiciary Committee passed the Standard Merger and Acquisition Reviews Through Equal Rules Act (SMARTER Act), which could affect how federal antitrust agencies evaluate healthcare mergers and...

Healthcare Consumerism Challenges Primary Care Business Models

by Jacqueline LaPointe

Primary care providers are facing significant and oftentimes conflicting challenges in response to two major healthcare trends: value-based purchasing implementation and the rise of healthcare consumerism, a recent Journal of Internal...

Physician Compensation for Specialists 45.6% More than for PCPs

by Jacqueline LaPointe

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...

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,...

AMGA Supports 15% Limit for Medicare Advantage Encounter Data

by Jacqueline LaPointe

AMGA recently applauded CMS for further reducing the percentage of encounter data to be used to determine Medicare Advantage enrollee risk scores from 25 percent in the proposed rule to 15 percent in the final 2018 performance year...

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...

Nurse Practitioner, Physician Assistant Salary Grew in 2016

by Jacqueline LaPointe

As nurse practitioner and physician assistant salary rates continue to rise, a recent PracticeMatch survey found that more advanced practitioners are also increasingly enjoying their jobs. The survey of over 1,000 nurse practitioners and...

Oncologist Org Opposes MedPAC Medicare Reimbursement Changes

by Jacqueline LaPointe

The Community Oncology Alliance (COA) recently expressed concerns that proposed Medicare reimbursement changes for Part B services from the Medicare Payment Advisory Commission (MedPAC) would drive cancer care to more higher-cost...

IL Supreme Court Maintains Non-Profit Hospital Tax Exemption

by Jacqueline LaPointe

The Illinois Supreme Court recently legally voided an appellate court’s decision that non-profit hospital tax exemption was unconstitutional. In Illinois, non-profit hospitals qualify for property tax exemption if the value of all...

OIG Releases Healthcare Fraud Compliance Program Guidelines

by Jacqueline LaPointe

The Office of the Inspector General (OIG) recently published guidelines on how healthcare organizations can measure the effectiveness of their healthcare fraud compliance programs. The resource guide explains how healthcare organizations...

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...

How to Prepare for Alternative Payment Model Implementation

by Jacqueline LaPointe

Implementing interoperable health IT infrastructure and a staffing model that aligns with value-based care requirements are key to successfully participating in an alternative payment model, Marjie Harbrecht, MD, a Medical Group...

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...

Physician Shortage Projected to Grow to 104K Providers by 2030

by Jacqueline LaPointe

The physician shortage is projected to grow to up to 104,900 providers by 2030, new research from the Association of American Medical Colleges (AAMC) revealed. The projected physician shortage increased from an estimated shortfall of up...

Tracking Key Hospital Revenue Cycle Metrics to Up Profitability

by Jacqueline LaPointe

As the value-based reimbursement transition rolls on, many hospitals have adopted “If you can measure it, you can manage it” as their new motto. But how can providers and executives measure hospital revenue cycle...

Hospitals Seek Independent Docs for Referrals, Healthcare Revenue

by Jacqueline LaPointe

A recent SCI Solutions survey found that 58 percent of independent providers do not have one or more preferred referral hospital partners, suggesting a major healthcare revenue opportunity for health systems and hospitals. Out of the 549...

52% of Practices Use Various Reminders to Stop Patient No-Shows

by Jacqueline LaPointe

To prevent patient no-shows, a recent Medical Group Management Association (MGMA) poll showed that providers are using a variety of communication methods to protect their healthcare revenue from missed appointments. The recent survey of...

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