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

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Healthcare Prices, Spending, Employment Decline in Early 2017

June 13, 2017 - Recent research from the Altarum Institute showed that healthcare prices, spending, and employment are all trending downward after a three-year period of healthcare spending acceleration. Healthcare employment growth declined by 10,000 per month since 2016, while price increases stabilized across clinical areas and healthcare spending growth decreased by 0.5 percent in the same period. “The...


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Medicare Cardiac, Ortho Bundled Payments Delayed Until 2018

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CMS recently delayed the launch date of three mandatory Medicare cardiac and orthopedic bundled payment models and the Cardiac Rehabilitation Incentive Payment program from May 20, 2017, to Jan. 1, 2018. The final ruling from the federal agency...

Third MI Provider Convicted in $17.1M Healthcare Fraud Case

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Healthcare fraud prevention and prosecution will continue to be a major area of focus for the Department of Justice (DoJ), Acting Assistant Attorney General Kenneth A. Blanco recently told the American Bar Association. With healthcare fraud draining...

CMS Opens Comprehensive Primary Care Plus Apps in 4 Regions

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CMS recently announced that the second round of the Comprehensive Primary Care Plus (CPC+) alternative payment model will launch in four regions in 2018. The four regions are Louisiana, Nebraska, North Dakota, and the greater Buffalo area of...

10 Orgs Call for Medicare Advantage APMs to Qualify for MACRA

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A coalition of ten healthcare industry groups recently urged HHS Secretary Tom Price to weigh risk-based Medicare Advantage alternative payment models the same as Advanced Alternative Payment Models under MACRA. Qualifying participants in MACRA’s...

Execs Say Value-Based Purchasing to Hit Tipping Point by 2020

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Over one-half (55 percent) of healthcare executives surveyed after the recent presidential election stated that the industry should reach the value-based purchasing tipping point before 2020, a recent Lazard report revealed. The survey of 203...

NYC Hospital Adds Epic Revenue Cycle Management to EHR System

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NYC Health and Hospitals Corporation (NYCHHC) recently selected to implement an Epic healthcare revenue cycle management solution to help the health system boost adjusted patient revenue by another 5 percent. The largest public health system...

House Reps Address Physician Shortage in Medicare Residency Bill

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House representatives Joseph Crowley (D-NY) and Ryan Costello (R-PA) recently introduced legislation that aims to resolve physician shortage challenges by adding more Medicare-funded residency positions. A summary of the Resident Physician Shortage...

VA, HHS Healthcare Staffing Agreement to Up Vet Care Access

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Secretary of Veteran Affairs David J. Shulkin, MD, recently announced a new partnership between the VA and HHS that aims to boost healthcare staffing at VA facilities to improve access to care and care coordination. The collaboration agreement...

Brigham and Women’s Offers Buyouts to Lower Healthcare Costs

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Boston-based Brigham and Women’s Hospital recently presented 1,600 employees with a voluntary buyout option in an effort to control the facility’s healthcare costs, a local news source reported. Hospital officials reassured reporters...

CMS Expects to Release MIPS Participation Status By May 2017

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CMS anticipates notifying eligible clinicians about their Merit-Based Incentive Payment System (MIPS) participation status for 2017 via letter between late April through May, a recent email from the federal agency stated. The announcement (via...

CMS Calls On Rural Hospitals to Join Alternative Payment Model

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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...

CMS Suggests Hospital Medicare Reimbursement Policy Changes

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CMS recently suggested changes to Medicare reimbursement policies for hospital admissions and long-term care hospital stays as well as several recommendations for other Medicare value-based purchasing programs. The proposed rule released on April...

32 Orgs to Cut Healthcare Costs, Use Under CMS Community Demo

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As part of the Accountable Health Communities Model, CMS recently selected 32 organizations to participate in two of the three program tracks that aim to lower healthcare costs and utilization by fostering clinical and community service provider...

CMS Pauses Home Health Pre-Claim Review Demonstration

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CMS recently halted the home health Pre-Claim Review demonstration in Illinois for 30 days and the program will not expand to Florida as expected in April 2017, according to the federal agency’s website. “After March 31, 2017, and...

AMGA President, CEO Donald W. Fisher, PhD, Passes at 71

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AMGA President and CEO, Donald W. Fisher, PhD, CAE, passed earlier this week after battling cancer, the healthcare industry group reported. Fisher, who was 71 years old, had led the organization since 1980. “Don leaves a professional and...

CMS Delays Rollout of Cardiac, Ortho Bundled Payment Programs

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CMS is pushing back the start date for a number of its bundled payment programs in an effort to provide additional time to review and prepare for the initiatives. In a notice posted in the Federal Register, CMS has issued three-month delays for...

Senate Confirms Seema Verma as Next CMS Administrator

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In a 55 to 43 vote yesterday, the Senate confirmed Seema Verma as the next CMS Administrator, according to a New York Times article. Verma, the founder, president, and CEO of a health policy consulting firm, will be charged with managing...

CMS Reopens Next Generation ACO Application Request Portal

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Providers interested in joining the Next Generation Accountable Care Organization (ACO) model in 2018 can now access the Request for Applications and Letter of Intent on the program’s portal, according to a recent CMS announcement. The...

CMS Calls on Stakeholders for Pediatric APM Development Input

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CMS recently put out a request for information for a potential Medicaid and Children’s Health Insurance Program (CHIP) alternative payment model targeting pediatric care, according to an official CMS blog post. “Through the RFI [request...

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