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

Healthcare Spending

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

April 25, 2018 - 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 more for their healthcare, they’re demanding more. They want quality and price transparency. This is just a response to the needs of patients,”...


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CMS to Require Healthcare Price Transparency Online for Hospitals

by Jacqueline Belliveau

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 Belliveau

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 Belliveau

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 Belliveau

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 Belliveau

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 Belliveau

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 Belliveau

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...

Price Transparency Crucial to Healthcare Consumerism Success

by Jacqueline Belliveau

Providers should brace their practices for the rise and permanence of healthcare consumerism, a new brief from Rice University’s Baker Institute for Public Policy stated. Healthcare consumers are expecting their experiences with providers...

Medical Prices Grew 28% for Hospital E&M Services Since 2012

by Jacqueline Belliveau

Medical prices for hospital evaluation and management (E&M) services rose 28 percent and allowed amounts increased 26 percent between May 2012 and 2017, the most recent FH Medical Price Index from FAIR Health revealed. The analysis of over...

Prices, Administrative Costs Drive Higher US Healthcare Spending

by Jacqueline Belliveau

High prices for provider compensation, healthcare services, and prescription drugs, as well as administrative costs, are responsible for increased healthcare spending in the US compared to other high-income countries, a new JAMA study revealed....

Senators Ask for Help with Quality, Healthcare Price Transparency

by Jacqueline Belliveau

A bipartisan group of six senators recently penned a letter to healthcare stakeholders calling for more information on healthcare price transparency to guide and inform a new legislative initiative. Senators Bill Cassidy, MD (R-LA), Michael Bennet...

Patient Financial Responsibility Increased 11% in 2017

by Jacqueline Belliveau

Patient financial responsibility is on the rise, according to findings from a TransUnion Healthcare analysis revealed at HIMSS18. Patients saw their average out-of-pocket costs increase 11 percent in 2017, growing from $1,630 in the fourth quarter...

EHR Adoption Does Not Lower Administrative, Medical Billing Costs

by Jacqueline Belliveau

Electronic health records (EHRs) did not reduce insurance-related and medical billing costs despite the federal government’s claims that EHR adoption would lower administrative expenditures, according to a recent Journal of the American...

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

by Jacqueline Belliveau

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...

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...

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