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

Healthcare Spending

GAO Advises CMS to Clarify RAC’s Medicare Audit Objectives

by Sara Heath

A recent study by the Government Accountability Office (GAO) has found that the Centers for Medicare & Medicaid Services (CMS) needs to be more hands-on when working with Medicare Part D recovery audit contractor (RAC) programs. CMS began...

Calif. Managed Care Organization Tax Proposal Axed

by Sara Heath

The managed care organization (MCO) tax in California has been causing quite a debate over the past year. After the Centers for Medicare & Medicaid Services (CMS) issued a letter to the state informing them that their current MCO tax model...

Public Market Financing Growth, Healthcare M&A Data Released

by Jacqueline DiChiara

Initial public offerings (IPOs), consumer-based initiatives, and mobile funding declines are shaping the current revenue cycle landscape, according to a new report from Mercom Capital Group on healthcare information technology (IT) funding...

How Mass General Hospital Excels in Revenue Cycle Management

by Jacqueline DiChiara

“How do you excel in revenue cycle management?” RevCycleIntelligence.com continues to ask hospital executives and leaders this simple yet intricate question to help advance the healthcare industry. As...

Are BHI and CCM Cost Effective Standards for Patient Care?

by Sara Heath

Behavioral health integration (BHI) is becoming increasingly important as physical health and mental health are being viewed as equally important to a patient’s overall health. However, in addition to examining the benefits of BHI, it might...

August 14: 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...

3 Simple Things to Know About Healthcare Spending’s Future

by Jacqueline DiChiara

Predicting the delicate future of healthcare cost and spending trends based on past algorithms, collected data implications, and the simple art of a strong financial guess based on knowledge and skill sets is an important aspect of understanding...

ACA Community Health Center Funds Increase Quality of Care

by Sara Heath

Under the Affordable Care Act (ACA), community health centers have seen tremendous growth, receiving funding to expand their services and healthcare sites to provide help to more individuals who may otherwise go without care. In honor of National...

CMS Announces Final Rule Implementing Quality Care in SNFs

by Sara Heath

Value-based payment and quality care continue to prove high on the Centers for Medicare & Medicaid Services’ (CMS) agenda. On July 30, the Centers for Medicare & Medicaid Services (CMS) announced their final rules for the fiscal...

Healthcare Reform Bill to Financially Support Mental Illness

by Sara Heath

Lack of mental health care causes major financial issues, costing approximately $193 billion in lost earnings and productivity, according to a recent new release. On August 4, Senators Bill Cassidy, MD, of Louisiana and Chris Murphy of Connecticut...

Healthcare Spending to Rise Despite Lack of Patient Input

by Sara Heath

Healthcare spending is expected to climb to enormous heights by 2024, according to a recent news release by the Citizen’s Council for Health Freedom (CCHF). According to Twila Brase, R.N and Co-Founder and President of CCHF, these rising...

NOTICE Act Helps Beneficiaries Understand Healthcare Costs

by Sara Heath

In a unanimous vote, the Senate passed the Notice of Observation Treatment and Implication for Care Eligibility Act (the NOTICE Act) on July 27, according to the American Hospital Association (AHA). On July 29, the bill was presented to...

Is Sustainability the Future of Healthcare Spending Growth?

by Jacqueline DiChiara

Healthcare spending growth is expected to increase throughout the next decade, according to newly released data from Health Affairs via the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary (OACT). Are future surmised numbers...

As Medicare Turns 50, Does It Still Make Financial Sense?

by Sara Heath

As Medicare’s 50th birthday approaches, critics begin to question whether the program should be rescued and updated for today’s health economy, or if it should be phased out and eventually dissolved, according to a news...

Will Insurance Mergers Drive Up Health Insurance Premiums?

by Jacqueline DiChiara

A series of pending healthcare mergers may lessen competition and leave beneficiaries with less choice. Aetna recently agreed to acquire Humana for $37 billion in cash and stock. The unification of two of the largest health insurers is expected...

$2 Billion Spent on Preventable Healthcare Costs, Says MHD Study

by Sara Heath

Preventable healthcare spending is on the rise, according to a Minnesota Health Department (MHD) analysis of state emergency department visits, hospital admissions, and hospital readmissions. The study showed that approximately 1.3 million of...

CMS Trustees Report Historic Low in Medicare Cost Growth

by Sara Heath

Growth in Medicare costs remains low, according to the Trustees report released on July 21 by the Centers for Medicare & Medicaid Services (CMS). The Trustees report indicates that the Medicare trust fund will remain solvent until 2030, which...

New Growth in Home and Community-Based Services Spending

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) has released its “milestone” 2013 Medicaid Expenditures for Long-Term Services and Supports Report. According to the Center for Medicaid and CHIP Services (CMCS), 2013 was the...

AHA Opposes HPID on HIPAA Transactions

by Sara Heath

On July 20, Ashley Thompson, Vice President and Deputy Director of the American Hospital Association (AHA), sent a letter on behalf of the AHA expressing opposition to the final rule on the Health Plan Identifier (HPID) and the Other Entity Identifier...

Price Transparency Laws Exclude Adequate Price Information

by Jacqueline DiChiara

Pricing Transparency laws paint a “bleak picture" with “much work to be done,” according to the third annual Catalyst for Payment Reform (CPR) – Health Care Incentives Improvement Institute (HCI) Report Card...

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