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

Healthcare Spending

Academic Medical Centers Receive More Value-Based Penalties

August 15, 2018 - Academic medical centers (AMCs) are key members of the healthcare industry, engaging in medical research, uncovering clinical breakthroughs, and training future providers. However, a new analysis by Navigant shows that the organizations are struggling to deliver value. AMCs received more overall value-based penalties between 2016 and 2018, with 40 percent of the medical centers getting...


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Prescription Drug Rate Growth to Slow in 2019, Increasing 4.92%

by Jacqueline LaPointe

Hospitals and health systems should anticipate prescription drug rates to increase by 4.92 percent in 2019, researchers from the healthcare improvement company Vizient recently estimated. Prescription drug rates for hospitals and health...

WA Makes Healthcare Price Transparency Consumer-Friendly

by Jacqueline LaPointe

How much does a knee replacement surgery cost at MultiCare Auburn Medical Center in Auburn, Washington versus St. Anthony Hospital in nearby Gig Harbor? Does EvergreenHealth Medical Center in Kirkland deliver the highest value birthing...

Medical Liability Immunity Reduces Defensive Medicine, Costs by 5%

by Jacqueline LaPointe

A new working paper by the National Bureau of Economic Research shows that medical liability immunity can change how a provider practices medicine by decreasing defensive medicine use and its associated healthcare costs. Providers ordered...

Healthcare Cost Control Rises to Top Hospital Exec Priority

by Jacqueline LaPointe

Healthcare cost control rose to the top of hospital leader priority lists, bypassing revenue growth for the first time, according to the Advisory Board’s most recent Annual Health Care CEO Survey. The survey of 146 C-suite...

Who Should be Held Accountable for Healthcare Costs?

by Jacqueline LaPointe

While the recent growth in patient financial responsibility has providers thinking about healthcare costs when making care decisions, many still do not think they should be held accountable for the costs of care, a recent survey showed. A...

Giving Providers Hospital Cost Accounting Data Will Lower Costs

by Jacqueline LaPointe

Engaging physicians with hospital cost accounting data will be key to lowering costs under accountable care organizations (ACOs) and other population-based reimbursement models, Stanford researchers recently explained. Population-based...

Providers Investing in Home Health to Prepare for Aging Population

by Jacqueline LaPointe

Faced with the pressure to reduce healthcare costs as the elderly population rapidly grows, providers plan to shift elder care from hospitals and skilled nursing facilities to the home, healthcare experts explained. According to CMS and...

How Addressing Social Determinants of Health Cuts Healthcare Costs

by Jacqueline LaPointe

Population health management and value-based reimbursement success hinge on reducing healthcare costs not only when a patient is in the exam room, but also when they are beyond the walls of the practice or hospital. Therefore,...

Quality Improvement Projects Save Children’s Hospitals Millions

by Jacqueline LaPointe

Care quality improvements require hospitals to invest their money, time, and staff. The investment may be large, but for two children’s hospitals it paid off, saving the organizations millions and reducing costly accidents and...

Healthcare Mergers, Increased Access to Boost Medical Costs 6%

by Jacqueline LaPointe

PwC’s Health Research Institute (HRI) predicts medical costs for employers to grow 6 percent in 2019 as healthcare mergers and more convenient care access options drive up healthcare costs and utilization. The medical cost trend is...

NJ Passes Healthcare Price Transparency Law to Stop Surprise Bills

by Jacqueline LaPointe

New Jersey policymakers are increasing healthcare price transparency in the state by enacting a new law intended to protect consumers from surprise bills for out-of-network health services. New Jersey Governor Phil Murphy signed Assembly...

ER Spending Rose 99% Since 2009 Despite No Change in Utilization

by Jacqueline LaPointe

Emergency room (ER) spending per person grew 99 percent between 2009 and 2016 despite ER utilization remaining the same during the period, new data from the Health Care Cost Institute (HCCI) revealed. “Emergency room visits are not...

4 Strategies for Providers to Improve Hospital Price Transparency

by Jacqueline LaPointe

Federal and state governments are ramping up efforts to increase hospital price transparency as consumers become more responsible for their healthcare costs under high-deductible health plans. However, provider organizations are...

Implants Driving Healthcare Cost Variation for Joint Replacements

by Jacqueline LaPointe

Hospitals have improved patient outcomes for total joint replacements, but the facilities still have a way to go with reducing healthcare cost variation for both hip and knee implants, a new Premier analysis revealed. The study of almost...

Shifting Vaccinations to the Pharmacy Lowers Healthcare Costs

by Jacqueline LaPointe

Pharmacies can administer a wide range of vaccines to patients at significantly lower healthcare costs than physician practices and other medical settings, a new report from the Pacific Research Institute found. The literature review...

Location, Market Competition Influence Hospital Price Variation

by Jacqueline LaPointe

Hospital prices for the privately insured depend on where a facility is located and how consolidated its market is, a recent Health Care Pricing Project analysis revealed. Using insurance claims from three of the largest commercial...

Giving GA Hospitals Healthcare Cost Data to Lowering Spending

by Jacqueline LaPointe

With claims reimbursement rates falling and competition among healthcare organizations intensifying, hospitals are calling on their providers to increase efficiency and reduce healthcare costs for each admission. So, what do providers...

Palliative Care Reduces Hospital Costs by Over $3K Per Patient

by Jacqueline LaPointe

Hospitals costs fell by an average of $3,237 per patient when providers added prompt palliative care to routine treatments during the course of a hospital stay, reported researchers from the Icahn School of Medicine at Mount Sinai and...

Industry Orgs Express Concerns with Healthcare Price Transparency

by Jacqueline LaPointe

Industry groups are cautioning a bipartisan group of Senators on the challenges and limitations of healthcare price transparency from the provider organization perspective after the policymakers called for more information on the topic...

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