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

Rural Hospitals

Over 1,300 Hospitals Urge CMS to Withdraw 340B Drug Payment Cuts

October 24, 2017 - Over 1,300 rural hospitals and other healthcare organizations that serve low-income communities added their voices to the growing list of stakeholders opposing proposed payment cuts to the 340B Drug Pricing program. CMS proposed in July 2017 to reduce hospital reimbursement for most 340B prescription drugs. Rather than paying eligible hospitals average sales price plus 6 percent, Medicare...


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In IRS First, Non-Profit Hospital Loses Status Under ACA Rules

by Jacqueline Belliveau

The IRS recently revoked a rural hospital’s non-profit status for failure to meet new community health needs assessment requirements under the Affordable Care Act. According to an IRS letter dated Feb. 14, 2017, the unnamed hospital lost...

Post-Acute Care Payment Reform Threatens Rural Hospitals

by Jacqueline Belliveau

A proposed unified Medicare reimbursement for post-acute care services and value-based care payment models, such as accountable care organizations (ACOs) and bundled payments, may propel rural hospital closures as the reforms lower their post-acute...

Top 4 Rural Hospital Challenges with Revenue Cycle Management

by Jacqueline Belliveau

Rural hospitals may be the only healthcare option for individuals living in sparsely populated areas, but revenue cycle management challenges have forced many of these facilities to permanently close their doors. The healthcare industry has seen...

41% of Rural Hospitals Operating with Negative Margins

by Jacqueline Belliveau

Approximately 41 percent of rural hospitals faced negative operating margins in 2016, a recent Chartis Group and iVantage Health Analytics study of over 2,100 rural hospitals revealed. Researchers added that rural hospitals located in states...

AHA Urges Rural, Post-Acute Care Medicare Reimbursement Reform

by Jacqueline Belliveau

In a Congressional hearing on the current status of Medicare reimbursement systems, the American Hospital Association (AHA) urged lawmakers to focus on rural hospital and post-acute care payments. MACRA extended a number of key Medicare reimbursement...

MIPS Requirements for Clinicians in Small, Rural Hospitals

by Jacqueline Belliveau

In light of the unique challenges eligible clinicians in small and rural hospitals face, CMS developed special Merit-Based Incentive Payment System (MIPS) eligibility and reporting requirements for the clinician group. Through MIPS, CMS aims...

CMS Calls On Rural Hospitals to Join Alternative Payment Model

by Jacqueline Belliveau

CMS is seeking applicants to participate in a new round of the Rural Community Hospital Demonstration Program that tests a cost-based alternative payment model among small rural hospitals. Lawmakers authorized a five-year extension of the demonstration...

Senators Push Bill to Address Physician Shortage in Rural Areas

by Jacqueline Belliveau

Three senators recently introduced a rural healthcare bill that would extend the Conrad State 30 Program until 2021 to help alleviate the physician shortage in designated Health Professions Shortage Areas or Medically Underserved Areas. Senators...

CMS Awards $100M for Small, Rural Clinician MACRA Help

by Jacqueline Belliveau

ORLANDO - CMS recently selected 11 healthcare organizations to receive a total of $100 million in funding to help small and rural eligible clinicians participate in the newly-launched MACRA. Each organization received $20 million to provide hands-on...

How a Rural Hospital Used Health IT, EHR to Stay Independent

by Jacqueline Belliveau

In a time of declining claims reimbursement rates and value-based care, rural hospitals are struggling more than ever to improve their healthcare revenue cycle management strategies. For many rural hospitals, the decision oftentimes comes down...

All-Payer Alternative Payment Model Targets PA Rural Hospitals

by Jacqueline Belliveau

A new six-year all-payer alternative payment model will focus on improving care quality and reducing healthcare costs at rural hospitals in Pennsylvania, CMS announced in a recent fact sheet. The CMS Innovation Center’s latest project,...

URAC Calls for Virtual Group Rules in Quality Payment Program

by Jacqueline Belliveau

URAC, a non-profit healthcare accreditation company, recently called on CMS to implement virtual group standards under the Quality Payment Program in 2018 that promote economies of scale for more activities than just reporting compliance. The...

GAO Finds Value-Based Care Issues for Small, Rural Practices

by Jacqueline Belliveau

A recent Government Accountability Office (GAO) report found that small and rural practices faced several challenges with implementing value-based care models, such as limited financial resources, a lack of interoperable health IT, population...

NY Senator Challenges Rural Medicare Reimbursement Repayment

by Jacqueline Belliveau

New York Senator Charles Schumer (D-NY) recently spoke out against a CMS plan to recoup supplemental Medicare reimbursement to rural hospitals that could cause hospitals in New York alone to repay the federal agency $15 to $20 million for payments...

Rural Hospitals Faced Less Value-Based Reimbursement Penalties

by Jacqueline Belliveau

Rural hospitals outperformed urban hospitals in several Medicare value-based reimbursement programs in 2015, receiving fewer financial penalties, according to a recent report from the Department of Health and Human Services (HHS). Researchers...

CMS: Rural Healthcare Faces Hospital Revenue Cycle Challenges

by Jacqueline Belliveau

In a statement at the CMS Rural Health Summit yesterday, CMS Acting Administrator Andy Slavitt identified rural communities as one of the biggest opportunities for healthcare reform because rural areas face more hospital revenue cycle challenges,...

How MACRA, MIPS Will Impact Critical Access Hospitals, FQHCs

by Catherine Sampson

MACRA means different things to various types of healthcare providers, such as critical access hospitals, rural health clinics and Federally Qualified Health Centers. Although the new MACRA framework provides multiple paths to success with various...

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...

Senate Committee Approves Rural Health Care Connectivity Act

by Jacqueline DiChiara

Those living in rural areas of the country without a hospital delivering affordable care nearby may soon be at ease due to passage of a new bipartisan bill. United States Senator John Thune (R-SD), Chairman of the Senate Committee on Commerce,...

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