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

Revenue Cycle Management

Medicaid Expansion Linked to $5M Annual Hospital Revenue Boost

by Jacqueline LaPointe

Hospital revenue in Medicaid expansion states increased by $5 million annually per facility after states chose to extend Medicaid coverage to more individuals, a recent Robert Wood Johnson Foundation and Urban Institute report showed. The...

Healthcare Mergers May Face New Federal Rules Under SMARTER Act

by Jacqueline LaPointe

In a 16 to 20 vote earlier this week, the House Judiciary Committee passed the Standard Merger and Acquisition Reviews Through Equal Rules Act (SMARTER Act), which could affect how federal antitrust agencies evaluate healthcare mergers and...

Healthcare Consumerism Challenges Primary Care Business Models

by Jacqueline LaPointe

Primary care providers are facing significant and oftentimes conflicting challenges in response to two major healthcare trends: value-based purchasing implementation and the rise of healthcare consumerism, a recent Journal of Internal...

Physician Compensation for Specialists 45.6% More than for PCPs

by Jacqueline LaPointe

According to a recent Medscape survey, physician compensation for specialists was 45.6 percent more than what primary care providers earned in the past year. The survey of over 19,200 physicians in 27 specialists uncovered that the...

Healthcare Costs Rise With Regional Post-Acute Care Variations

by Jacqueline LaPointe

Despite receiving similar post-acute care services overall, rural hospital patients tend to undergo more skilled nursing facility treatment than home health care versus urban hospital patients, contributing to higher healthcare costs,...

Lean Primary Care Improves Physician Productivity, Costs

by Jacqueline LaPointe

A recent American Journal of Managed Care study showed that implementing a Lean primary care model resulted in operational cost reductions, physician productivity improvements, and higher patient satisfaction scores. “Our findings...

Is Radiation Overuse Contributing to Higher Healthcare Costs?

by Jacqueline LaPointe

Oncologists could have saved over $164 million in healthcare costs if they had adhered to clinical guidelines and prescribed shorter radiation treatment for some breast cancer patients, a recent Journal of Oncology Practice study...

IL Supreme Court Maintains Non-Profit Hospital Tax Exemption

by Jacqueline LaPointe

The Illinois Supreme Court recently legally voided an appellate court’s decision that non-profit hospital tax exemption was unconstitutional. In Illinois, non-profit hospitals qualify for property tax exemption if the value of all...

Physician Shortage Projected to Grow to 104K Providers by 2030

by Jacqueline LaPointe

The physician shortage is projected to grow to up to 104,900 providers by 2030, new research from the Association of American Medical Colleges (AAMC) revealed. The projected physician shortage increased from an estimated shortfall of up...

Hospitals Seek Independent Docs for Referrals, Healthcare Revenue

by Jacqueline LaPointe

A recent SCI Solutions survey found that 58 percent of independent providers do not have one or more preferred referral hospital partners, suggesting a major healthcare revenue opportunity for health systems and hospitals. Out of the 549...

52% of Practices Use Various Reminders to Stop Patient No-Shows

by Jacqueline LaPointe

To prevent patient no-shows, a recent Medical Group Management Association (MGMA) poll showed that providers are using a variety of communication methods to protect their healthcare revenue from missed appointments. The recent survey of...

Top 4 Claims Denial Management Challenges Impacting Revenue

by Jacqueline LaPointe

For most healthcare organizations, claim denials are a normal, if not a frequent, occurrence. While very few can boast that their denial rates are close to zero, many providers face a number of challenges with implementing an effective...

NH Judge Rejects CMS FAQs Clarifying Medicaid DSH Payments

by Jacqueline LaPointe

A district court in New Hampshire recently prohibited CMS from enforcing two Frequently Asked Questions (FAQs) that clarified how private payer and Medicare reimbursements paid to hospitals for dually-eligible Medicaid patients would be...

Healthcare RCM, Patient Collections Solutions Launch at HIMSS17

by Jacqueline LaPointe

ORLANDO - With over 40,000 healthcare stakeholders milling around Orlando’s Orange County Convention Center for HIMSS17, big and small vendors were eager to show off the latest and greatest products in healthcare revenue cycle...

Health Systems, Physicians See Significant Revenue Losses in 2015

by Jacqueline LaPointe

Both integrated healthcare systems and private physician practices saw operating losses in 2015, according to a revenue cycle management survey conducted by the American Medical Group Association. Integrated healthcare systems saw an...

Reducing Use of Low-Value Services Cuts Healthcare Costs

by Jacqueline LaPointe

Providers can substantially lower their healthcare costs by reducing the use of low-value services, even though these services account for a substantially small portion of healthcare spending, according to a recent study by the RAND...

88% Improve Claims Submissions Using Revenue Cycle Analytics

by Jacqueline LaPointe

According to a Navicure survey, medical organizations that used a revenue cycle analytics or business intelligence solution were able to boost performance on key healthcare revenue cycle metrics. About 88 percent of participants reported...

Healthcare Costs Concerns Impact Provider Rationing Behavior

by Jacqueline LaPointe

It is not uncommon to hear patients say that healthcare costs are going up, especially as more individuals enroll in high-deductible health plans. But, some providers oftentimes question if they should be responsible for helping to control...

74% of Providers See Increased Patient Financial Responsibility

by Jacqueline LaPointe

A recent report from InstaMed found that 74 percent of healthcare providers reported an increase in patient financial responsibility in 2015, which has prompted healthcare revenue cycle management strategies to focus more on...

Patient Billing Challenges Revenue Cycle Management

by Catherine Sampson

Patient payment and billing are significant revenue cycle management challenges that should not be ignored.  According to a recent survey conducted by Navicure, 63 percent of participants recognized that patient payment processes were...

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