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

Healthcare Spending

MSSP ACOs Save More By Spending Less on Inpatient, Post-Acute Care

February 23, 2018 - Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) have shifted their spending to physician services and away from inpatient and skilled nursing facility care, according to a recent study in the American Journal of Accountable Care. The analysis of within-ACO changes between the program’s first performance year in 2013 and the most recent complete performance...


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Addressing Prices, Use at Local Level to Lower Healthcare Costs

by Jacqueline Belliveau

Local patterns of healthcare utilization and pricing resulted in significant healthcare costs variation across five states, a new Network for Regional Healthcare Improvement (NRHI) report showed. NRHI’s second annual report, Healthcare...

Medicare Spending, Prices Drive Healthcare Spending Growth

by Jacqueline Belliveau

The healthcare share of the economy should reach 19.7 percent by 2026 as the average annual rate of national healthcare spending growth rate and Medicare spending accelerates, the CMS Office of the Actuary recently projected. The data, published...

Providers Skeptical Practice Variation Reduction Will Lower Costs

by Jacqueline Belliveau

Clinicians strongly agreed that providers should be responsible for reducing healthcare costs, but fewer clinicians felt that decreasing practice variation would lower costs, a recent Plos One study uncovered. The survey of over 170 physicians,...

Drug Prices, Medicaid Reform Major Themes in Trump’s HHS Budget

by Jacqueline Belliveau

President Trump plans to decrease HHS funding by about 21 percent compared to 2017, while focusing the federal department’s budget on prescription drug prices reductions and Medicaid reform, according to the 2019 fiscal year budget plan. Alongside...

Blue Cross NC Says Carolinas, UNC Hospital Merger Will Raise Costs

by Jacqueline Belliveau

The potential hospital merger deal between Carolinas HealthCare System and UNC Health Care recently hit another roadblock. Blue Cross Blue Shield of North Carolina (Blue Cross NC) announced that the organization opposes the proposed health system...

Healthcare Supply Chain Management Market to Reach $2.3B by 2022

by Jacqueline Belliveau

Growing at a compound annual growth rate (CAGR) of 8.4 percent, researchers projected the global healthcare supply chain management market to reach $2.31 billion by 2022, a recent Markets and Markets report showed. The value of the healthcare...

Prescription Drug Rate Growth Slows, But Prices Still Rising 7.35%

by Jacqueline Belliveau

Providers should anticipate a 7.35 percent increase in prescription drug rates between July 2018 and June 2019, researchers from Vizient projected in a new study. Based on hospital and non-acute facility purchasing data from the company’s...

Reducing Low-Value Care Key to Value-Based Reimbursement Success

by Jacqueline Belliveau

Value-based reimbursement success hinges on decreasing low-value care across patient populations, explained Scott Weingarten, MD, MPH, Senior Vice President and Chief Clinical Transformation Officer at Cedars-Sinai Medical Center. While hospitals...

AMGA: Link Spending, Quality Performance for True Value-Based Care

by Jacqueline Belliveau

In response to a Request for Information from the Assistant Secretary for Planning and Evaluation (ASPE), AMGA recently called on CMS to “define value in a meaningful way” to ensure value-based care models incentivize providers to...

Team-Based Care for Kidney Disease Saves Park Nicollet $1.2M

by Jacqueline Belliveau

End-stage renal disease comes with a hefty price tag for both patients and providers. But Park Nicollet Health Services, an integrated care system in Minnesota, found that a team-based care approach to late-stage kidney disease helped to drastically...

Health Systems Form Drug Company to Combat Rising Costs, Shortages

by Jacqueline Belliveau

Intermountain Healthcare, Ascension, SSM Health, and Trinity Health recently announced that they will create a non-profit generic drug company to reduce prescription costs and alleviate critical drug shortages. With consulting services with the...

CDC Urges Providers to Improve Asthma Care as Costs Soar to $81.9B

by Jacqueline Belliveau

The annual costs of asthma care, including medical expenses, absenteeism, and mortality, cost the US economy $81.9 billion in 2013, researchers from the Centers for Disease Control and Prevention (CDC) recently reported. And that value may be...

Healthcare Costs, Outcomes Vary When VA Outsources Cardiac Care

by Jacqueline Belliveau

Veterans seeking cardiac care at community hospitals may lower their travel expenses, but they also face varying healthcare costs and mortality rates by stepping outside the VA’s healthcare system, a recent JAMA Cardiology study revealed....

New CO Law Requires Providers to Give Patients Healthcare Prices

by Jacqueline Belliveau

A new healthcare price transparency law in Colorado now requires providers to give patients the costs of the most common procedures they perform. Patients should receive a list of the prices for the 15 most common services delivered at the provider...

Judge Denies Hospital Org Attempt to Block 340B Drug Payment Cut

by Jacqueline Belliveau

A federal judge recently ruled that CMS can start to reduce 340B drug payments to hospitals by $1.6 billion starting on Jan. 1, 2018, striking a blow to several industry groups that urged the court to delay enforcement of the new rule. US District...

Care Coordination, Community Health Workers Reduce ED Costs, Use

by Jacqueline Belliveau

Average direct emergency department costs dropped 15 percent for frequent emergency department users after Brigham and Women’s hospital implemented a care coordination program using community health workers, according to a recent study...

Long-Term Healthcare Spending Doesn’t Aid Heart Attack Survival

by Jacqueline Belliveau

Healthcare spending on 180 days of heart attack care grew 14.4 percent since 1999, but patient morality rates remained constant for heart attack patients after the 30-day discharge period when the bulk of spending growth occurred, a recent JAMA...

74% of Younger Patients Underpay Patient Financial Responsibility

by Jacqueline Belliveau

Nearly three-quarters of younger individuals did not pay their patient financial responsibility in full in 2016, a recent Transunion survey found. Millennials, or individuals between 23 and 37 years old, were significantly less likely to completely...

Top 10 ICU Diagnoses Driving Up Healthcare Costs, Care Variations

by Jacqueline Belliveau

Cardiac procedures and sepsis dominated the list of top ten intensive care unit (ICU) diagnoses that represented the greatest opportunity for hospitals to reduce healthcare costs and care variations for ICU length of stay, a recent Premier Inc....

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