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

Hospital Revenue Cycle

Revenue Cycle Management Must Change for Community Hospitals

by Jacqueline LaPointe

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,...

AHA Endorses Quality Reporting Software for Value-Based Care

by Jacqueline LaPointe

The American Hospital Association (AHA) recently announced that it has endorsed ENCOR Quality Reporting and Management Solution from Medisolv Inc. for providing services and products that help member healthcare providers improve...

Lack of Medicaid Expansion Leads to Hospital Revenue Loss

by Vera Gruessner

Ever since a number of states refused to expand their Medicaid programs and receive the majority of funding for this enterprise from the federal government, there has been a division of revenue between states that have broadened Medicaid...

Epic Systems Tops List of Hospital RCM Technology Users

by Kyle Murphy, PhD

The healthcare industry finds itself at a turning point in regard to reimbursement. Fee-for-service reimbursement is giving way to alternative payment models that emphasize value over volume, but it remains a financially significant...

Medicaid Expansion Decisions Cost Hospitals, States Billions

by Jacqueline DiChiara

Medicaid expansion rejection is costing various states across the nation a great deal of money. The voluntary decision to not implement Medicaid expansion is potentially harmful for revenue cycle management. Expansion states have been...

Price Transparency Still Missing from Hospital Revenue Cycle

by Jacqueline DiChiara

The Affordable Care Act’s (ACA) numerous price transparency provisions are inefficient, says a policy brief from the Pioneer Institute. Hospital executives must make consumer-friendly pricing information a top revenue cycle focus or...

Patient Accounting Systems Disrupt Revenue Cycle Management

by Jacqueline DiChiara

Most hospitals experienced a noteworthy revenue cycle management performance disruption following recent conversion of their patient accounting systems (PAS), according to a new Crowe Horwath benchmark report.   Technological...

EHR Documentation Policies Improve Revenue Cycle Management

by Jacqueline DiChiara

Revenue cycle management can reap substantial benefits from improved electronic health record (EHR) documentation. But the learning curve is perhaps still too steep to move forward without stumbling. Many physicians consider...

4 Revenue Cycle Management, Claims Reimbursement Strategies

by Jacqueline DiChiara

Organized claims processing and accurate payment help maintain strong revenue cycle management.  But keeping track of claims reimbursement processes and operations involves a great deal of seemingly convoluted steps.  The life...

The Affordable Care Act’s Effect on Hospital Charity Care

by Jacqueline DiChiara

Hospitals provide charity care according to patients’ income levels. But policies and patient criteria often vary depending on the particular hospital. Supporting hospital charity care while maintaining tight margins is a challenge,...

How Medicare Accountable Care Organizations Keep CAHs Afloat

by Jacqueline DiChiara

Medicare accountable care organizations (ACOs) are finally smoothing out regional hospitals' revenue cycle wrinkles. But successful ACOs still need to adopt tighter standards to remain financially viable. Critical...

CMS Reports SNF Payment Incentives May Cut Medicare Spending

by Jacqueline DiChiara

Medicare spending is falling, according to an annual report from the Centers for Medicare & Medicaid Services (CMS) that assessed how to reduce avoidable hospitalizations for long-stay nursing facility...

Why Executives are Demanding Supply Chain Management Value

by Jacqueline DiChiara

As hospitals transition into the value-based payment realm, they remain focused on effectively slashing costs. Supply chain management is the second largest expense for healthcare providers, according to a study from Cardinal Health and...

Why Hospital Revenue Cycle Demands More Patient Engagement

by Jacqueline DiChiara

A lack of technological alignment may cause hospital revenue cycle to dip substantially, according to research from Accenture. Stronger patient engagement efforts and revision of digital health strategies may help hospitals protect their...

Is Data Collection too Burdensome in CMS Final Payment Rule?

by Jacqueline DiChiara

A new 311 page final rule from the Centers for Medicare & Medicare Services (CMS) aims to amend the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment...

Why Focusing on Hospital Readmission Causes Is Essential

by Jacqueline DiChiara

The ongoing payment transition from volume to value is bringing the concept of forced alignment into the spotlight. Hospitals, unsure what new outpatient services are best to implement, are now focused on making effective choices. Are such...

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...

CMS Awards $110M in ACA Funds to Cut Avoidable Readmissions

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) has awarded $110 million to 17 national, regional, and state hospital associations and health system organizations to help slash preventable hospital readmissions. CMS’...

Are Medicare Pay-for-Performance Benefits Worth the Risk?

by Jacqueline DiChiara

Medicare pay-for-performance (P4P) incentives are inadvertently averting money away from those financially aching hospitals primarily serving minorities and the economically disadvantaged to instead inflate the revenues of those hospitals...

How to Rescue Revenue Cycle with Medicare Appeals Pending

by Jacqueline DiChiara

The rehabilitation needs of Medicare beneficiaries within the state of California may be in jeopardy. Payment for hundreds of thousands of claims for services is being denied. Most of these denials are reportedly invalid, confirms past...

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