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

Healthcare Spending

Expensive Hepatitis C Drugs Quadrupled Prescription Spending

by Jacqueline DiChiara

Healthcare spending for the privately insured has steadily increased over the last 5 years, confirms today’s fifth annual healthcare spending report from the Health Care Cost Institute (HCCI). An eclectic rollercoaster of various numbers...

Is U.S. Healthcare Really a Big Spender in Global Contrast?

by Jacqueline DiChiara

Healthcare spending nationwide is more expensive in comparison with our international neighbors due to greater medical technology implementation and higher healthcare prices, confirms a Commonwealth Fund issue brief. But is the U.S. really that...

PA Receives $886K Award in CCBHC Behavioral Disorder Funding

by Jacqueline DiChiara

It is perhaps becoming increasingly difficult to peruse the news without stumbling across a story on behavioral health. Whether bombs are falling in Boston or bullets are flying across a college campus, both political debates and Monday morning...

Performance-Based Pay Hot as Healthcare Exec Salaries Rise

by Jacqueline DiChiara

Median base healthcare salaries are on the up and up, according to recently released results within a 2015 executive healthcare and hospital compensation survey press release from Sullivan, Cotter and Associates. Data collected from...

How to Achieve Value Within the Value-Based Care Transition

by Jacqueline DiChiara

The Department of Health and Human Services (HHS) is on a mission to associate 90 percent of Medicare payments to value within the next three years and Congressional passage of the Medicare Access and CHIP Reauthorization Act of 2015...

CMS Streamlines Medicaid Managed Care Process Via Rate Guide

by Sara Heath

Managed care delivery systems are an integral part of the Medicaid and Children’s Health Insurance Plan (CHIP) programs, with nearly 80 percent of Medicaid and CHIP enrollees served via managed care. The high number of individuals served...

MGMA: Healthcare Facility Operations Spending Grows By 12%

by Sara Heath

As the needs of healthcare facilities continue to increase, practices are spending more money on enhanced technology and nonphysician providers (NPPs), according to a Medical Group Management Association (MGMA) press release. In the Cost and...

4 Autumn Predictions for Congressional Healthcare Agenda

by Jacqueline DiChiara

In a personal interview with, Joel White, President of the Council for Affordable Health Coverage, presents four key congressional healthcare agenda items that he says have a fair shot of reaching the president...

Healthcare Pricing Trends Suggest Marketplace Complexity

by Sara Heath

Is your healthcare marketplace “healthy?” A recent economic metrics analysis tool developed by the Health Care Cost Institute (HCCI) seeks to answer that question. The Healthy Marketplace Index Report (HMI), funded by the Robert Wood...

Primary Care Providers Benefit from Large ACA Donations

by Sara Heath

The Department of Health & Human Services (HHS) has allocated $500 million in Affordable Care Act (ACA) funding to aid health centers and increase primary care services, according to a recent press release. The goal of this funding matches...

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?” 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...


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