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

Healthcare Spending

Advisory Group Warns CMS Against 340B Medicare Reimbursement Cuts

by Jacqueline Belliveau

The CMS Advisory Panel on Hospital Outpatient Payment recently called on the federal agency to abandon proposed changes to the 340B Drug Pricing Program in 2018, which would reduce Medicare reimbursement to qualifying hospitals for drugs acquired...

Readmissions, Post-Acute Care Drive Variation in Bundled Payments

by Jacqueline Belliveau

Hospital readmissions, professional fees, and post-acute care payments are key drivers of cost variations for providers participating in 90-day cardiac bundled payment models, a recent JAMA Surgery study revealed. “These results underscore...

Scarce Public Health Funds Block Social Determinants of Health Aid

by Jacqueline Belliveau

As value-based care emphasizes preventative medicine, healthcare stakeholders aim to address social determinants of health to improve and maintain outcomes. But the lack of appropriate public health funding at federal, state, and local government...

Accountable Care Organization Saves $4.8M With Nutrition Aid

by Jacqueline Belliveau

A case study in American Health & Drug Benefits showed that Advocate Health Care, an accountable care organization in the Chicago area, reduced healthcare costs by $3,800 per patient, or $4.8 million in total, by implementing a nutrition...

Hospitals Turning to Staff Buyouts to Reduce Healthcare Costs

by Jacqueline Belliveau

Massachusetts-based Brigham and Women’s Hospital may extend a voluntary buyout offer to employees in order to reduce healthcare costs in the face of growing labor expenses and stagnant claims reimbursement rates. In April 2017, the hospital...

Patient-Reported Data Helps Providers Find High-Cost Patients

by Jacqueline Belliveau

Self-reported patient data on health conditions, status, and utilization may be the key to identifying high-cost patients and guiding them to care management models to reduce their spending, a recent American Journal of Managed Care study indicated....

Primary Care Job Growth Slows, Affecting Healthcare Spending

by Jacqueline Belliveau

With the number of specialist jobs rising nearly six times faster than primary care provider positions between 2005 and 2015, industry efforts to control and reduce healthcare spending may be in trouble, a recent Health Affairs blogpost suggested....

Complex Surgery Costs 10.5% Less With Hospital Consolidation

by Jacqueline Belliveau

Overall healthcare charges for complex pancreatic and hepatic surgeries were 13.4 percent lower in markets with higher levels of hospital consolidation than charges for the same operations in unconcentrated and moderately concentrated markets,...

Hospitals to See 7.61% Rise in 2018 Prescription Drug Rates

by Jacqueline Belliveau

Hospitals and health systems should anticipate a 7.61 percent increase in prescription drug rates in 2018, researchers predicted in a recent Vizient study. Using the group purchasing organization’s 2016 and 2017 data on hospital and non-acute...

Free Health Clinics Face ROI, Clinical Efficiency Obstacles

by Jacqueline Belliveau

Free health clinics help uninsured and low-income individuals access affordable care, but two recent studies show that free clinics may face healthcare costs and clinical efficiency challenges. New research in the Journal of the American Board...

Provider Compensation Rises 2.9%, While Productivity Flattens

by Jacqueline Belliveau

Physicians experienced similar physician compensation increases in 2016 compared to last year, with median compensation rising by 2.9 percent after a 3.1 percent boost in 2015, the most recent AMGA Medical Group Compensation and Productivity...

Beth Israel, Lahey Health Ink Final Healthcare Merger Agreement

by Jacqueline Belliveau

Boston-based Beth Israel Deaconess health system and Lahey Health recently finalized a healthcare merger agreement after about seven months of negotiations. Despite several failed attempts at a healthcare merger in the past, the two health systems...

Healthcare Costs Up 47.2% Despite Little Change in Utilization

by Jacqueline Belliveau

Healthcare costs increased 47.2 percent from $246 per individual per month in 1996 and 1997 to $362 per individual per month in 2011 and 2012 despite healthcare utilization and the number of individuals seeking care remaining relatively unchanged...

Designing Care Models to Treat High-Need, High-Cost Patients

by Jacqueline Belliveau

A recent report from the National Academy of Medicine (NAM) explored how healthcare organizations can identify high-need, high-cost patients and implement care models that appropriately address the needs of the population to reduce healthcare...

Group Purchasing Increases Healthcare Supply Chain Savings

by Jacqueline Belliveau

Group purchasing organizations (GPOs) increased healthcare supply chain savings between 10 percent and 18 percent by reducing transaction costs and supplier prices, a recent Healthcare Supply Chain Association (HSCA) study revealed. The literature...

Pediatric Healthcare Costs 35% Less at Community Health Centers

by Jacqueline Belliveau

Pediatric healthcare costs were $1,133 on average among children primarily using community health centers for care versus $1,750 among children seeing other providers, representing a 35 percent difference, a recent Geiger Gibson/RCHN Community...

Targeting Healthcare Cost Cuts Slows Revenue Cycle Performance

by Jacqueline Belliveau

Health system and hospital revenue cycle fell behind in key performance areas, such as claim denials management and bad debt, because the organizations prioritized healthcare cost reductions over revenue cycle performance, a recent Advisory Board...

Hospital Execs Look to Operations to Control Healthcare Costs

by Jacqueline Belliveau

With 78 percent of hospital leaders stating that rising healthcare costs are their primary concern in 2017, the leaders agreed that reviewing and optimizing existing operational and clinical processes was the hospital’s top strategy for...

Do Financial Benchmarks Truly Measure ACO Savings, Spending?

by Jacqueline Belliveau

Healthcare stakeholders should not use financial benchmarks developed by CMS to evaluate actual accountable care organization (ACO) savings, three Harvard Medical School experts in a recent Health Affairs blogpost. As Medicare ACOs grow in popularity,...

96% of Healthcare Execs Report Rise in Inpatient Drug Spending

by Jacqueline Belliveau

Approximately 64 percent of healthcare executives reported that inpatient drug spending at their organization significantly increased over the past five years, a recent Premier Inc survey revealed. Another 32 percent said that it somewhat...

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