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

Latest RCM News News

Pres Trump Taps Former Pharma Exec Alex Azar as Next HHS Secretary

November 14, 2017 - President Trump recently nominated Alex M. Azar II as the next HHS Secretary, according to multiple news sources. Azar was the former president of Eli Lilly’s American division and a health official in the George W. Bush Administration. If confirmed by the Senate, Azar would succeed Tom Price as head of the federal department. Price resigned in September after accusations that he spent...


Articles

CMS Cancels Home Health Groupings Model, $950M Reimbursement Cut

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CMS recently scrapped the proposed Home Health Groupings Model. The model would have used clinical and patient characteristics rather than the current therapy service use thresholds to determine Medicare reimbursement for home health agencies....

CMS Finalizes 2018 Hospital, Physician Medicare Reimbursement

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In a series of final rules released earlier this month, CMS updated and modified Medicare reimbursement rates for hospitals and physicians in 2018. The rules aim to “reflect a broader Administration-wide strategy to create a healthcare...

CMS Issues 2018 MACRA Implementation, Quality Payment Program Rule

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CMS recently issued a final 2018 MACRA implementation rule, detailing the requirements for Quality Payment Program participation in 2018. “CMS listened to feedback from the healthcare community and used it to inform policy making,”...

Accountable Care Organizations Cut Medicare Spending by $836M

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Accountable care organizations (ACOs) decreased Medicare spending by $836 million in 2016, new data from CMS revealed. As a result, the organizations from four Medicare ACO programs returned about $70.6 million in healthcare savings to the Medicare...

Tenet Cuts 1,300 Jobs as Part of $150M Cost Reduction Initiative

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Tenet Healthcare Corporation recently announced the elimination of approximately 1,300 jobs as part of the health system’s effort to reduce annual operating costs by $150 million by the end of 2018. The Dallas-based health system will implement...

Healthcare Merger, Acquisition Activity to Rise Despite Slow Q3

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Healthcare mergers and acquisition activity in the third quarter of 2017 may be down by 11 percent compared to last year and 6 percent compared to last quarter. But deal volume still reached over 200 announced transactions for the twelfth quarter...

Trevor Fetter Steps Down as Tenet Healthcare Corp CEO, Director

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Tenet Healthcare Corporation CEO Trevor Fetter stepped down earlier than expected as head of the health system. He also resigned as director of the company, Tenet recently announced. The health system stated in August 2017 that Fetter would no...

382 Hospitals Earn Initial Reconciliation Payments Under CJR Model

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Out of approximately 800 hospitals required to participate in Medicare’s Comprehensive Joint Replacement (CJR) model, 382 facilities will receive a reconciliation payment based on cost savings and care quality, according to preliminary...

Tenet Starts Chicago Market Exit with Sale of MacNeal Hospital

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Tenet Healthcare Corporation recently announced that Loyola Medicine has signed a definitive agreement to purchase MacNeal Hospital, one of Tenet’s four hospitals in the Chicago area. Loyola Medicine, an affiliate of Trinity Health, will...

Healthcare Price Growth Hits Lowest Rate in About Two Years

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Healthcare price growth in August 2017 increased by just 1.2 percent compared to the previous year, reaching the lowest growth rate in nearly two years and only three-tenths above the lowest growth rate ever recorded by Altarum Institute’s...

Healthcare RCM Vendors ZirMed and Navicure Announce Merger

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Healthcare revenue cycle management vendors Navicure and ZirMed recently announced that the organizations signed a definitive agreement to merge. Navicure will supposedly acquire ZirMed in a deal that values at about $750 million, sources told...

HHS Offers Special Medicare Reimbursement After Hurricane Irma

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In the wake of Hurricane Irma, HHS re-opened the National Disaster Medical System (NDMS) Definitive Care Reimbursement Program, a special Medicare reimbursement program that ensures hospitals and other medical facilities receive payment for the...

Tenet Sells Remaining Philly Hospitals, Announces Divestitures

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Tenet Healthcare Corporation will no longer own hospitals in Philadelphia after the Dallas-based company recently sold Hahnemann University Hospital and St. Christopher’s Hospital for Children for $170 million. The national healthcare organization...

Carolinas HealthCare, UNC Health Announce Healthcare Merger

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Carolinas HealthCare System and UNC Health Care recently announced their intentions to engage in a healthcare merger that would create one of the largest non-profit systems in the nation. The two North Carolina-based health systems signed a Letter...

CMS Offers Value-Based Purchasing Exceptions After Hurricane Harvey

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  Providers practicing in areas affected by Hurricane Harvey will not have to report to several Medicare and Medicaid quality reporting and value-based purchasing programs, CMS recently announced in an...

OK Physician Pays $580K to Settle Medicare Fraud Allegations

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A physician from Oklahoma recently agreed to pay $580,000 to settle a Medicare fraud case in which the federal government alleged that he submitted false claims to the federal healthcare program, the  Department of Justice (DoJ) announced....

MSSP ACOs Decreased Spending by $1B, Improved Care Quality

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Accountable care organizations (ACOs) participating in the first three years of the Medicare Shared Savings Program (MSSP) reduced Medicare spending, with a net reduction of almost $1 billion, according to a new OIG report. The analysis of 428...

CMS Cancels Medicare Billing Changes for Partial Hospitalizations

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CMS revoked Medicare reimbursement changes to its medical billing requirements and process for partial hospitalization services, according to a recent Medicare Learning Network announcement. The federal agency originally introduced the Medicare...

New Medicare Fraud Audits to Ease Burden on Compliant Providers

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CMS recently updated its Medicare fraud and improper payment audit process to target providers and suppliers who continually demonstrate high medical billing error rates, according to the federal agency’s website. The new Targeted Probe...

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