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

Hospital Reimbursement

CMS Suggests Hospital Medicare Reimbursement Policy Changes

April 17, 2017 - CMS recently suggested changes to Medicare reimbursement policies for hospital admissions and long-term care hospital stays as well as several recommendations for other Medicare value-based purchasing programs. The proposed rule released on April 14 contained multiple Medicare program updates for 2018 and a request for information on how to reduce administrative burdens stemming from CMS initiatives....

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Does Higher Hospital Profitability Drive Up Healthcare Costs?

by Jacqueline Belliveau

The push to maximize hospital profitability across for- and non-profit organizations is driving up healthcare costs, contends a new commentary in The American Journal of Medicine. Hospitals are focusing on boosting profitability rather than reducing...

Wisconsin Hospital Questions Hospital Profitability Study

by Catherine Sampson

In a hospital profitability study, researchers from Health Affairs drew the conclusion that Gundersen Lutheran Medical Center earned a profit of $302.5 million, or $4,241 per patient, in 2013. However, Gundersen Lutheran Medical Center claimed...

Value-Based Care Leads to Higher Costs for Surgical Complications

by Catherine Sampson

As a result of recent efforts to bring value-based care to the reimbursement cycle, it’s now more important for both providers and payers to gain an understanding about the link between costs and surgical complications, according to a recent...

CMS Plans to Reverse Two-Midnight Rule for Medicare Payments

by Catherine Sampson

On April 18, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that addresses the problematic two-midnight rule that produced 0.2 percent payment reductions for certain hospital inpatient services. The new rule would...

Rural Hospitals May Get Senate Help with Medicare Reimbursements

by Catherine Sampson

As the healthcare industry shifts from volume to value, hospitals are expected to provide quality care as many could also potentially face lower Medicare reimbursements. At the same time, many hospitals in rural and economically distressed areas...

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...

Provider Communication Key for Success in Bundled Payments

by Vera Gruessner

The Centers for Medicare & Medicaid Services (CMS) has established a number of different healthcare reimbursement strategies including pay-for-performance, alternative payment models, and bundled payments. For instance, the CMS Comprehensive...

Accountable Care Organizations Renew Hospital Reimbursement

by Jacqueline DiChiara

Accountable Care Organizations (ACOs) may be a welcome hospital reimbursement innovation for the critical access community. Critical care organizations far away from the hustle and bustle of a nearby city face a different set of reimbursement...

Rural Hospitals Address Medicare Reimbursement Cut Concerns

by Jacqueline DiChiara

Rural hospitals may be losing the Medicare reimbursement battle. Legislative pushes are being considered by Congress to alleviate the possible financial death of the rural hospital as reimbursement cuts continue to weaken the financial backbone...

Quincy Medical Closure Delayed by Noncompliance

by Ryan Mcaskill

Potential contract and law violations could keep Quincy Medical Center from closing by the end of 2014. Earlier this month, covered the closure announcement of Quincy Medical Center, which serves patients in the Greater...

Reimbursement, Regulation the Biggest Challenges to Telehealth

by Ryan Mcaskill

A new study found that telehealth may be the next shift in healthcare, but it is an uphill battle. The use of telemedicine is growing in the healthcare landscape. The Affordable Care Act and the expansion of accountable care strategies places...


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