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

Healthcare Spending

June 5: Week That Was in Healthcare Fraud and Malpractice

by Jacqueline DiChiara

Here is a general roundup of the past week’s developments in healthcare fraud and malpractice, as reported by the Department of Justice and the Office of Inspector General. The crimes reported below result in multiple millions of dollars...

Is Consumer-Centric Revenue Cycle Management the Solution?

by Jacqueline DiChiara

Is revenue cycle management in need of a drastic overhaul? As the ever evolving landscape of the healthcare industry continuously adjusts its sails, revenue cycle management may be continuously falling backwards amidst antiquated winds. A...

Does a Half Billion HIE Investment Create ROI?

by Jacqueline DiChiara

Following a decade of healthcare’s investment in health information exchange (HIE) platforms, the healthcare industry enters a state of reflection and analysis regarding what the return on investment implications may be. The Office of the...

Healthcare Experts’ Top 5 Accountable Care Organization Tips

by Jacqueline DiChiara

Accountable care organizations (ACOs) and accountable care models have existed on the forefront of the healthcare industry as an emerging and dynamic focus for healthcare providers, payers, and executives. As recent initiatives within the past...

Healthcare Experts Speak Out on Rural Hospitals’ Medicare Cuts

by Jacqueline DiChiara

As RevCycleIntelligence.com recently reported, recent Congress testimony from 4 rural hospital leaders representing the Centers for Medicare & Medicaid Services (CMS) demanded urgently implemented change to alleviate rural hospitals’...

CMS’s Transparency Gaps Yield Invalid Medicare Payment Rates

by Jacqueline DiChiara

The overall accuracy of Medicare payment rates significantly impacts the collective healthcare system. Medicare payment rate haste makes waste. Improved data and transparency efforts will dramatically improve accuracy within the healthcare...

AMA Backs House Bill Aimed to Freeze ICD-10 Implementation

by Jacqueline DiChiara

Earlier this month, the House proposed a new bill, H.R. 2126, the Cutting Costly Codes Act of 2015, aimed at freezing ICD-10 CM/PCS implementation. The bill intends to prohibit Sylvia M. Burwell, Secretary of the Department of Health and Human...

$6.9B in Medicare Expenditures for Mental Health Care Costs

by Jacqueline DiChiara

Many individuals receiving care under the Medicaid umbrella lack insurance protection regarding mental health expenditures. A limitation of such coverage was lifted via the implementation of Mental Health Parity and Addiction...

Per Capita Diabetes Spending Soars to $10,000 per Person

by Jacqueline DiChiara

Diabetes is expensive. The disease is costing the healthcare industry billions of dollars. In 2012, an estimated $245 billion was spent on medical costs and productivity loss because of diabetes, confirms data collected between 2010 and...

$101M ACA Health Center Funding Increases Healthcare Access

by Jacqueline DiChiara

$101 million in Affordable Care Act funding will go toward the delivery of comprehensive primary health services at 164 new health center sites across 33 states. The objective of such funding – the New Access Point Grant Awards –...

Does Medicare Part D Prescriber Data Improve Transparency?

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) has announced the availability of updated privacy-protected data on Medicare Part D prescription drugs. The presented data explains which prescription drugs were prescribed to Medicare...

Streamlined Core Measures Advance Cost-Effective Healthcare

by Jacqueline DiChiara

Improved health at lower cost means paying special attention to magnified metrics. This task is no simple feat. Although there are currently thousands of possible core measures providing healthcare professionals, payers, policy makers, and beneficiaries...

MACRA Fee Adjustments May Generate Financial Consequence

by Jacqueline DiChiara

Physicians and healthcare providers may endure an even greater financial consequence under the $200 billion Medicare reform package signed by President Obama last week, H.R. 2, the Medicare Access and CHIP Reauthorization Act (MACRA) than before...

ICD-10 Compliance: From Provider Uncertainty to Certainty

by Jacqueline DiChiara

Tick tock goes the ICD-10 clock. As the ICD-10 implementation October 1, 2015 date looms closer, hesitation within the healthcare industry blossoms as providers struggle to stay in the game. Can general uncertainty around the implementation...

Physician-Led ACOs Need Opportunities to Thrive

by Jacqueline DiChiara

Many of the HIMSS15 educational sessions this week in Chicago offered valuable insight into the financial future of the healthcare industry. Farzad Mostashari, MD, ScM, Aledade Inc. Founder and CEO and former National Coordinator...

April 17: Week That Was in Healthcare Fraud and Malpractice

by Jacqueline DiChiara

Here is a general roundup of the past week’s developments in healthcare fraud and malpractice, as reported by the Department of Justice and the Office of Inspector General. The crimes reported below result in multiple millions of dollars...

Mechanized Claims Processing the Future of Medicaid?

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) present a proposed rule to extend enhanced federal financial participation for Medicaid eligibility and enrollment systems beyond the...

Value-Based Reimbursement: Humana CEO’s Payer Perspective

by Jacqueline DiChiara

In a Tuesday morning keynote speech at the Healthcare Information and Management Systems Society’s (HIMSS’) annual HIMSS15 conference and exhibition conducted this week in Chicago, Bruce D. Broussard, CEO and President of Humana,...

AMA CEO: Flawed SGR No Longer Threatens Payment Delivery

by Jacqueline DiChiara

James L. Madara, MD, Chief Executive Officer and Executive Vice President of the American Medical Association (AMA), provided insight via a morning media conference today on the organization’s perspective regarding the Senate’s overwhelmingly...

$100B Aftermath of Medicare Access, CHIP Reauthorization Act

by Jacqueline DiChiara

The ongoing push for value-based reimbursement endures with the finalization of new legislative decisions regarding the permanent SGR repeal's ripple effect on the healthcare industry at large. The Medicare Access and CHIP...

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