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

Medicare and Medicaid Services

Why HOPD Medicare Expenditures Need Equalized Payment Rates

by Jacqueline DiChiara

Medicare expenditures for hospital outpatient departments (HOPD) services are apparently on the rise, especially in recent years. A new report to Congressional requesters from the United States Government Accountability Office (GAO)...

Pew Recommends CMS Reconsider EHR Advance Care Plan Updates

by Jacqueline DiChiara

Making decisions in life is not always easy. End-of-life care decisions are no exception. The Centers for Medicare & Medicaid Services (CMS) recently proposed numerous revisions to the physician payment system under MACRA. The...

Dec. 18: 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 (OIG). The crimes reported below result in multiple millions...

CMS Shares New Qualified Entity Program Growth Developments

by Jacqueline DiChiara

It is an exciting time for healthcare, says the Centers for Medicare & Medicaid Services (CMS). Notable transparency developments are underway, wrote Niall Brennan, CMS Chief Data Officer and the Director of the Office...

ICD-10 News the Landslide Leader in 2015’s Top 10 Stories

by Jacqueline DiChiara

Just as driving a car with your eyes permanently glued to the rearview mirror is not necessarily the most intelligent decision, catching a glimpse every now and then of your current whereabouts is essential. When it comes to continued...

Why Successful Healthcare Executives Focus on Education

by Jacqueline DiChiara

The Affordable Care Act (ACA) aims to increase the number of people with health insurance by expanding Medicaid coverage nationwide. Are targets being hit or merely glossed over? Medicare Part D beneficiaries make up the bulk of the...

December 11: 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 (OIG). The crimes reported below result in multiple millions...

Why Patient Advocacy is the New Future of Healthcare Reform

by Jacqueline DiChiara

There is power in numbers, especially when it comes to healthcare reform. A group of 9 major patient advocacy groups – AIDS United, American Liver Foundation, Amputee Coalition, the Christopher & Dana Reeve Foundation,...

Is Increased Medicaid Coverage the Chronic Disease Solution?

by Jacqueline DiChiara

What do Manhattan rents, Ferraris, college tuition, and chronic disease all have in common? They are all really expensive. What is especially problematic is that chronic diseases are not only very costly, but also very common within the...

Hospitals Facing More Payment Claims Audits, Costly Denials

by Jacqueline DiChiara

Hospitals are allegedly trying to do the best they can, even when money is slow to come in. Nearly half of all Recovery Audit Contractor claim denials are denied by hospitals, according to a new report from the American Hospital...

Senate Votes to Repeal Affordable Care Act, Reactions Ensue

by Jacqueline DiChiara

The United States Senate voted 52-47 last night in support of the Restoring Americans’ Healthcare Freedom Reconciliation Act (H.R. 3762.) This bill, which repeals segments of the Affordable Care Act, apparently slashes the...

December 4: 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 (OIG). The crimes reported below result in multiple millions...

CMS Confirms More Affordable 2016 Medicare Part B Premiums

by Jacqueline DiChiara

Healthcare consumers’ wallets will apparently be a tad fuller next year. 2016 will not see a cost of living increase for those under Social Security, according to an announcement from the Centers for Medicare & Medicaid...

CMS Announces Two-Midnight Payment Cut Commentary Period

by Jacqueline DiChiara

A notice and accompanying commentary period released yesterday from The Centers for Medicare & Medicaid Services (CMS) examines the core issue behind slashing hospital inpatient payments by 0.2 percent. This financial cut is tied to a...

CMS Reports $2.4B in Healthcare Consumer ACA Premium Rebates

by Jacqueline DiChiara

Consumers are apparently receiving major bang for their buck, although not in relation to this week’s hard-to-miss Black Friday and Cyber Monday holiday sales brouhaha. Healthcare consumers have received over $2.4 billion premium...

CMS Approves Outpatient Ambulatory Patient Experience Survey

by Jacqueline DiChiara

How can you best measure patient experience? Perhaps with a 37-question survey. The Centers for Medicare & Medicaid Services (CMS) has approved the administration of an Outpatient and Ambulatory Surgery Consumer Assessment of...

CMS Announces Top 3 Volume to Value Medicare Payment Goals

by Jacqueline DiChiara

Patrick Conway, MD, MSc, Chief Medical Officer at the Centers for Medicare & Medicaid Services (CMS), is speaking out about the administration’s overarching goals for Medicare’s future. In yesterday’s blog...

How Physician Shortages Are Transforming Healthcare’s Future

by Jacqueline DiChiara

Just as Rome was not built in a day, neither is a doctor. Training a physician can take up to a decade; the Colosseum was perhaps ironically built in less time. With predictions of massive physician shortages gaining headway across the...

Why Value-Based Care Yields Lower Cost, Higher Quality Care

by Jacqueline DiChiara

Value-based care is in the lead compared to its fee-for-service competitor, according to Humana’s new Medicare Advantage population health results. “Members treated under the care of providers in value-based reimbursement...

Nov. 20: 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...

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