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

Healthcare Revenue Cycle

Healthcare Employment Shifting to Hospital-Employed Providers

by Jacqueline Belliveau

Physician practice owners no longer make up the majority of patient care providers, a recent American Medical Association (AMA) healthcare employment study revealed. Approximately 47 percent of patient care providers had a full or part ownership...

86% of Providers Saw Prior Authorization Requirements Increase

by Jacqueline Belliveau

Approximately 86 percent of medical practice leaders reported that prior authorization requirements have increased over the past year, a recent MGMA survey of over 1,000 leaders found. Only 3 percent stated that prior authorization requirements...

Lab Experts Help Providers Reduce Low-Value Resource Use, Costs

by Jacqueline Belliveau

Collaboration between laboratory medicine experts and clinicians is critical to reducing unnecessary and low-value resource use for value-based purchasing success, the American Association For Clinical Chemistry (AACC) recently stated. “The...

Only 40% of ED Providers Identified Accurate Healthcare Costs

by Jacqueline Belliveau

Emergency department providers have little understanding of the healthcare costs associated with common visits, a recent Journal of the American Osteopathic Association study revealed. The survey of over 400 healthcare professionals working in...

Commitment Key to Successful Value-Based Reimbursement Adoption

by Jacqueline Belliveau

It is time for healthcare providers to move past understanding the concept and start the value-based reimbursement adoption process. Otherwise, they may face profitability decreases from operating both fee-for-service and alternative payment...

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...

Healthcare Framework Aims to Drop Low-Value Resource Use, Costs

by Jacqueline Belliveau

Healthcare organizations looking to reduce low-value resource use and healthcare costs should implement a framework that addresses the patient and clinician interaction, according to a recent Journal of Hospital Medicine report. Four physicians...

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...

Medicare Appeals Backlog Delays Decision Process By 4.5 Years

by Jacqueline Belliveau

Hospitals waited an average of 1,663.3 days, or a little over 4.5 years, to conclude the Medicare reimbursement audit and appeals process because of the extensive Medicare appeals backlog, a recent Journal of Hospital Medicine study uncovered....

Do NP, PA Ordering Habits Lead to Higher Healthcare Costs?

by Jacqueline Belliveau

Nurse practitioners and physician assistants did not contribute to higher healthcare costs by ordering more ancillary or expensive services compared to primary care providers, a recent American Journal of Managed Care study uncovered. The analysis...

56% of Top Performing Med Groups Plan Value-Based Purchasing

by Jacqueline Belliveau

About 56 percent of medical groups that were financially high-performing have a plan for a value-based purchasing transition versus just 32 percent of medical groups falling behind with healthcare revenue cycle management, a recent CareCloud...

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...

Post-Acute Care Network Key to Value-Based Purchasing Success

by Jacqueline Belliveau

Health systems should develop a post-acute care network and strategy to succeed in value-based purchasing models, a recent Deloitte survey indicated. The survey of 36 executives from health systems, payers, post-acute care organizations, and...

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...

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