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

Healthcare Spending

Primary Care Initiative Continues to Reduce Medicare Spending

by Jacqueline Belliveau

The Comprehensive Primary Care Initiative (CPC) continued to improve quality of care and reduce Medicare spending in 2015 even though the initiative has yet to generate net healthcare savings, according to an official CMS blog post. In the initiative’s...

AHA Calls for Hospital Access to Prescription Drug Rate Info

by Jacqueline Belliveau

The American Hospital Association (AHA) recently urged the Health Resources and Services Administration (HRSA) to grant hospitals in the 340B Drug Pricing Program more access to prescription drug rate information. In a comment letter on a proposed...

Hospitals Saw 23% Rise in Inpatient Prescription Drug Spending

by Jacqueline Belliveau

Hospital inpatient prescription drug spending has increased by 23.4 percent from 2013 to 2015, reported a recent study from the University of Chicago’s NORC. The increases in spending have left most providers struggling to manage their...

GAO: Healthcare Spending Data from CMS Inaccessible, Unreliable

by Jacqueline Belliveau

CMS should make healthcare spending data for skilled nursing facilities more accessible to public stakeholders and ensure the expenditure information is reliable, the Government Accountability Office (GAO) advised the federal agency in a recent...

Medical Device Reps in OR Sway Healthcare Supply Chain Costs

by Jacqueline Belliveau

Medical device sales representatives may act as key resources for surgeons on the latest technological advances and how to properly use specific devices, but the close relationship may actually be driving up healthcare supply chain costs, according...

Pharma Payments Influence Prescription Drug Spending

by Jacqueline Belliveau

Payments from pharmaceutical manufacturers may be more influential on physician prescribing habits than concerns over the rise in prescription drug spending, according to a recent study in the BMJ. Researchers found that small payments from pharmaceutical...

Cardiac Care Bundled Payment Model to Generate Modest Savings

by Jacqueline Belliveau

The recently proposed Medicare bundled payment model for cardiac care will likely bring only modest shared savings or losses to participants, according to a study from Avalere Health. About 85 percent of providers that will be required to take...

Monitoring Care Delivery Key to Reducing Healthcare Costs

by Jacqueline Belliveau

Lowering actual healthcare costs that providers incur while delivering care to patients is the key to making healthcare more affordable, according to a new Chilmark Research study. While payers are reforming claims reimbursement models to reduce...

Medicare ACOs Reduce Healthcare Spending On Complex Patients

by Jacqueline Belliveau

While one of the primary goals of joining an accountable care organization (ACO) is to coordinate care in effort to reduce healthcare spending, many Medicare ACO participants have seen early benefits from the alternative payment model. According...

End-of-Life Medicare Spending 25% Higher for Younger Seniors

by Jacqueline Belliveau

For most providers, it is not surprising that Medicare spending tends to increase in the last year of a beneficiary’s life, especially since this population is more likely to experience a serious illness and multiple chronic conditions....

$2.75B in Unexpected Healthcare Spending Impacts VA Budget

by Jacqueline Belliveau

The Department of Veteran’s Affairs (VA) has encountered $2.75 billion in unanticipated healthcare spending  during the 2015 fiscal year due to an increase in community care program participation and new hepatitis C drugs, according...

Providers Spend $15.4B to Report on Healthcare Quality Measures

by Catherine Sampson

General internists, family physicians, cardiologists, and orthopedists spend more than $15.4 billion annually to report on healthcare quality measures set by payers, according to a report from Health Affairs. Annually, these four types of practices...

Providers Prioritize Quality Care, Not Lower Healthcare Costs

by Jacqueline Belliveau

By now, many healthcare providers are partaking in some form of value-based care, which aims to foster quality care while reducing healthcare costs. To achieve this, value-based care relies on care coordination to decrease unnecessary treatments...

Do Nurse Practitioners Increase Healthcare Spending Rates?

by Catherine Sampson

While the use of independent nurse practitioners (NPs) is often seen as an important way to drive down healthcare spending rates, a new report from researchers at the University of California San Francisco indicates that the positive...

Affordable Care Act Increases Spending For Newly Insured

by Catherine Sampson

As the Affordable Care Act (ACA) brings more patients into the healthcare system, spending is on the rise, especially on chronic diseases, such as diabetes, heart disease and depression. Blue Cross Blue Shield (BCBS) backs this point in a recent...

Cancer Costs Don’t Rise Faster than Other Healthcare Spending

by Jacqueline Belliveau

Cancer-related healthcare costs have increased at almost the same rate as non-cancer healthcare spending since 2004, according to a recent study by Milliman and the Community Oncology Alliance. The study counteracts the common misbelief that...

$628K Awarded to Boost US Healthcare Spending Research

by Jacqueline Belliveau

The Peterson Center on Healthcare has awarded a $628,000 grant to the University of Washington’s Institute for Health Metrics and Evaluation (IHME) to analyze US healthcare spending and predict future spending trends, a recent statement...

Medicare Spending Increases Slightly under Affordable Care Act

by Jacqueline Belliveau

In 2014, Medicare spending for personal healthcare expenditures only increased by 2.4 percent per person and decreased by 3.6 percent for Medicaid, a recent report by the Department of Health and Human Services (HHS) stated. In comparison, overall...

Revenue Cycle Management Must Change for Community Hospitals

by Jacqueline Belliveau

Community hospitals in Massachusetts will continue to close if they do not make appropriate changes to their revenue cycle management strategies, a study reveals. The study, released by the Health Policy Commission (HCP) in Massachusetts, shows...

Why Concierge Medicine Programs Boost Patient Satisfaction

by Vera Gruessner

Due to the many complications of healthcare reform and the many quality care initiatives being established by federal agencies and payers, both new and well-established alternative healthcare delivery models are cropping up. Concierge medicine...

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