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

Healthcare Spending

Quality Improvement Projects Save Children’s Hospitals Millions

June 21, 2018 - 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 unnecessary utilization. Children’s hospitals manage a unique population compared to general acute care facilities. But their mission is the same as all...


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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 consistent...

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 Bill...

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 planned....

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 struggling to...

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 350...

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 showed that...

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 insurers (Aetna,...

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 need to...

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 Trinity...

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 earlier...

Addressing Productivity, Labor to Bend the Healthcare Cost Curve

by Jacqueline LaPointe

From alternative payment models and value-based purchasing to artificial intelligence and data analytics tools, the healthcare industry is transforming how care is delivered and paid for to reduce constantly rising medical costs. While payment...

“Just the Beginning” of Healthcare Price Transparency, Verma Says

by Jacqueline LaPointe

Requiring hospitals to post a list of their standard charges online is just the beginning of the push for increased healthcare price transparency by CMS, explained the federal agency’s Administrator Seema Verma. “As people are paying...

CMS to Require Healthcare Price Transparency Online for Hospitals

by Jacqueline LaPointe

CMS is updating its healthcare price transparency guidance to hospitals in a new proposed rule. The rule would require hospitals to make a list of their standard charges public via the Internet. Through guidelines, the federal agency already...

Healthcare Prices Hit Highest Annual Growth Rate Since Jan 2012

by Jacqueline LaPointe

The growth rate for healthcare prices increased 2.2 percent in March 2018 compared to the previous year, representing the greatest annual growth rate since January 2012, revealed the most recent Health Care Price Index from Altarum. Hospital...

Slowing Employment Key to Reducing Healthcare Costs, Experts Argue

by Jacqueline LaPointe

Despite industry-wide efforts to cut spending, healthcare costs are unlikely to decrease unless the industry also reduces the growth in employment, professors from the Geisel School of Medicine, Dartmouth College and Kennedy School of Government,...

3 Strategies to Decrease Low-Value Care, Healthcare Costs

by Jacqueline LaPointe

Low-value care, or care for which the potential harm outweighs the possible benefits or there are little to no benefits, is unnecessarily driving up already high healthcare costs and putting providers at risk under value-based reimbursement models....

CA Sues Sutter Health Over Healthcare Cost, Competition Concerns

by Jacqueline LaPointe

California’s Attorney General Xavier Becerra recently announced that the state filed a lawsuit against Sutter Health that accuses the largest health system in Northern California of engaging in anticompetitive behavior that resulted in...

Hospital Care at Home Cuts Healthcare Costs in Half at MA Hospital

by Jacqueline LaPointe

Healthcare costs for an acute care episode were 52 percent lower when acutely ill patients received hospital care at home, rather than being placed in a hospital bed, according to a recent study in the Journal of General Internal Medicine. The...

Oncologists Charge 9 to 51% More for Physician-Administered Drugs

by Jacqueline LaPointe

Median charges for physician-administered drugs covered under Medicare Part B were 9 to 51 percent higher at the oncologist than other specialty offices, researchers from Memorial Sloan Kettering Cancer Center and Johns Hopkins University recently...

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