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

Latest RCM News News

Emory Healthcare, Walmart Team Up for an ACO, Bundled Payments

April 23, 2018 - Atlanta-based Emory Healthcare recently announced the creation of an accountable care organization (ACO) with retail giant Walmart, known as the Accountable Care Plan. Walmart employees at 55 Walmart, Sam’s Club, and Walmart Distribution Center locations in the metro-Atlanta region have been able to enroll in the Accountable Care Plan since Jan. 1, 2018. The employees in the ACO program...


Banner Health Pays $18M to Resolve Medicare Fraud Accusations


Banner Health, one of the largest non-profit hospital systems in the country, recently agreed to pay $18 million to the federal government to resolve Medicare fraud allegations involving 12 of its hospitals in Arizona and Colorado, the Department...

CA Sues Sutter Health Over Healthcare Cost, Competition Concerns


California’s Attorney General Xavier Becerra recently announced that the state filed a lawsuit against Sutter Health that accuses the largest health system in Northern California of engaging in anticompetitive behavior that resulted in...

Advocate, Aurora Hospital Merger Deal Earns Regulatory Approval


Federal and state authorities recently gave the proposed hospital merger between Illinois-based Advocate Health Care and Wisconsin-area Aurora Health Care the greenlight, the health systems announced in a joint press release. The health systems...

UNC Health Care, Atrium Health Scrap Hospital Merger Deal


North Carolina-based UNC Health Care and Atrium Health recently announced that they will no longer pursue a hospital merger deal that would create one of the largest health systems in the country. “After months of discussions and due diligence,...

Bon Secours, Mercy Health Engaging in Hospital Merger Talks


Maryland-based Bon Secours Health System recently announced its intent to engage in a hospital merger deal with Mercy Health in Ohio and Kentucky. The Catholic health systems are currently engaged in merger talks, with a final deal expected to...

State Green Lights Partners, Mass. Eye and Ear Hospital Merger


Massachusetts public health officials recently approved a proposed hospital merger between the state’s largest hospital system, Partners HealthCare, and specialty hospital Massachusetts Eye and Ear. The Public Health Council unanimously...

Addressing Regulatory Burden, Patient Payments Top HIMSS18 Trends


Healthcare finance professionals can bet on discussing compliance, innovative health IT systems, and patient financial responsibility at the 2018 HIMSS Annual Conference and Exhibition (HIMSS18) in Las Vegas. Over 45,000 healthcare stakeholders...

Partners, Care New England Move Ahead with Hospital Merger Deal


Partners HealthCare of Massachusetts recently announced that it has signed a definitive hospital merger agreement to add Rhode Island-based Care New England Health System to its hospital system. The health systems signed a letter of intent to...

CMS Opens Low Volume Appeals Settlement to Reduce Appeals Backlog


In the face of a growing Medicare appeals backlog, CMS opened the first round of a low volume appeals settlement on Feb. 5 for providers with less than 500 claim denial appeals stuck in the appeals backlog at the Office of Medicare Hearings and...

Healthcare Supply Chain Management Market to Reach $2.3B by 2022


Growing at a compound annual growth rate (CAGR) of 8.4 percent, researchers projected the global healthcare supply chain management market to reach $2.31 billion by 2022, a recent Markets and Markets report showed. The value of the healthcare...

CMS Extends Home Health Enrollment Suspension to Combat Fraud


In an effort to reduce Medicare fraud, CMS announced in a new rule that it will extend a moratorium on enrollment of new Medicare home health agencies in Florida, Illinois, Michigan, and Texas. The federal agency also suspended enrollment of...

VA Leverages CMS Data Analytics to Reduce Healthcare Fraud, Waste


The country’s two largest public-private healthcare payment systems, the VA and CMS, recently announced that they will partner to reduce healthcare fraud, waste, and abuse for veterans using data analytics tools. “The VA-HHS alliance...

Senate Confirms Former Pharma Exec Alex Azar as Next HHS Secretary


Former Eli Lilly executive Alex Azar will now head the Department of Health and Human Services (HHS) after Senators confirmed his nomination this afternoon in a 55 to 43 vote. The Trump Administration nominated Azar back in November 2017 after...

CMS Welcomes 58 Next Generation ACO Model Participants in 2018


In 2018, the Next Generation ACO model will have a total of 58 participating accountable care organizations (ACOs), up from 45 organizations the previous year, CMS recently announced on the program’s Innovation Center webpage. The class...

Health Systems Form Drug Company to Combat Rising Costs, Shortages


Intermountain Healthcare, Ascension, SSM Health, and Trinity Health recently announced that they will create a non-profit generic drug company to reduce prescription costs and alleviate critical drug shortages. With consulting services with the...

Global Healthcare RCM Software Market to Reach $43.3B by 2022


The global market for healthcare revenue cycle management software will grow at a compound annual growth (CAGR) rate of 6.9 percent from 2017 to 2022, researchers from Future Market Insights recently predicted. At that growth rate, they estimate...

Voluntary Bundled Payments Launch, HHS Nominee Backs Mandatory APMs


CMS announced a new voluntary bundled payments opportunity starting in late 2018 on the same day that HHS Secretary nominee Alex Azar seemingly backed mandatory alternative payment models during a Senate Finance committee hearing. The new voluntary...

MSSP Accountable Care Organizations Moving to Risk in 2018


According to a new fact sheet from CMS, the Medicare Shared Savings Program (MSSP) will see some fresh faces in 2018, as well as more accountable care organizations (ACOs) entering downside financial risk tracks. The federal agency reported that...

CMS Releases Quality Payment Program Data Submission System


Eligible clinicians participating in MACRA’s Quality Payment Program can now start submitting their 2017 performance data on a new system on the program’s website, CMS recently announced in a press release. Medicare clinicians must...

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