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

Healthcare Revenue Cycle

High-Cost Patients Widely Distributed Across Hospitals, Markets

by Jacqueline Belliveau

A recent American Journal of Managed Care study attempting to understand why some patients incur higher healthcare costs than others found that high-cost patients were evenly spread across providers and healthcare markets. Using a 20 percent...

Is Billing Some Patients at Hospital Chargemaster Rates Legal?

by Jacqueline Belliveau

Contract law does not uphold the medical billing practice of charging uninsured or out-of-network insured patients hospital chargemaster rates that are not based on actual healthcare costs or market-negotiated prices, argued authors of a recent...

Healthcare Price Variation a Challenge for State, Local Leaders

by Jacqueline Belliveau

Local leaders may be better positioned to solve healthcare cost challenges than the federal government since healthcare price variation was more significant by state and local markets, a new Health Care Cost Institute (HCCI) and Robert Wood Johnson...

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...

Boost Healthcare Competition to Drive Down Prices, Up Quality

by Jacqueline Belliveau

The lack of healthcare competition stemming from recent healthcare merger and acquisition trends resulted in higher prices and lower care quality, industry experts recently argued in a Carnegie Mellon University’s Heinz College white paper....

Senators Push Bill to Address Physician Shortage in Rural Areas

by Jacqueline Belliveau

Three senators recently introduced a rural healthcare bill that would extend the Conrad State 30 Program until 2021 to help alleviate the physician shortage in designated Health Professions Shortage Areas or Medically Underserved Areas. Senators...

TN Law Aims to Make Payer Contract Management More Predictable

by Jacqueline Belliveau

Earlier this week, Tennessee Governor Bill Haslam signed the Provider Stability Act into law, which intends to increase transparency and accountability for payer contract management. Effective Jan. 1, 2019, the law will require payers in the...

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...

Healthcare Mergers May Face New Federal Rules Under SMARTER Act

by Jacqueline Belliveau

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 acquisitions....

Healthcare Consumerism Challenges Primary Care Business Models

by Jacqueline Belliveau

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 Medicine...

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...

Healthcare Costs Rise With Regional Post-Acute Care Variations

by Jacqueline Belliveau

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, according...

AMGA Supports 15% Limit for Medicare Advantage Encounter Data

by Jacqueline Belliveau

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 update. “It...

Lean Primary Care Improves Physician Productivity, Costs

by Jacqueline Belliveau

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 indicate...

Is Radiation Overuse Contributing to Higher Healthcare Costs?

by Jacqueline Belliveau

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 revealed. Only...

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

by Jacqueline Belliveau

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 collection...

Nurse Practitioner, Physician Assistant Salary Grew in 2016

by Jacqueline Belliveau

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 physician...

Oncologist Org Opposes MedPAC Medicare Reimbursement Changes

by Jacqueline Belliveau

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 settings. “MedPAC...

IL Supreme Court Maintains Non-Profit Hospital Tax Exemption

by Jacqueline Belliveau

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 charitable...

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