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

Practice Management News

Only 23% Have Consumer-Centered Healthcare Capabilities

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While approximately two-thirds of healthcare leaders view consumer-centered healthcare as a priority, especially in light of value-based reimbursement, only 23 percent stated that their organization had the capabilities to develop consumer insights,...

Does Higher Hospital Profitability Drive Up Healthcare Costs?

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The push to maximize hospital profitability across for- and non-profit organizations is driving up healthcare costs, contends a new commentary in The American Journal of Medicine. Hospitals are focusing on boosting profitability rather than reducing...

PCP Awareness of Healthcare Costs Cuts Low-Value Resource Use

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Healthcare organizations can cut down on costly low-value services, such as antibiotic prescriptions for acute sinusitis or osteoporosis screenings for young patients, by educating primary care providers about healthcare costs, a recent study...

How to Improve Healthcare Mergers and Acquisitions Strategies

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Large and mid-size healthcare organizations should implement more proactive healthcare mergers and acquisitions strategies to avoid common acquisition mistakes, such as undefined growth strategies and deal overpayments, asserted Deloitte in a...

90% Report Clinical Documentation Improvement Boosted Revenue

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Nearly 90 percent of hospitals with 150 or more beds and outsourced clinical documentation functions realized at least $1.5 million in appropriate healthcare revenue and claims reimbursement following clinical documentation improvement (CDI)...

How to Adopt a Retail Approach to Boost Healthcare Transparency

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More hospitals are implementing healthcare transparency strategies that borrow from the retail industry in order to retain and attract consumers, according to a recent PricewaterhouseCoopers Health Research Institute report. The report found...

GA Provider Receives Jail Time for a Healthcare Fraud Scheme

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A Georgia-area provider has recently been sentenced to three years and two months in prison stemming from a healthcare fraud case, the Department of Justice (DoJ) reported. Robert E. Windsor of Georgia was charged with fraudulent medical billing...

86% Say Provider Compensation Tied to Fee-for-Service, Salary

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About 86 percent of primary care physicians and specialists reported that their provider compensation was still primarily under fee-for-service or salary arrangements, representing a modest increase from 84 percent in 2014, according to a recent...

Benefits, Challenges of Value-Based Health IT Implementation

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From EHR systems to mHealth apps, health IT has the potential to help providers achieve value-based care goals. But with hundreds of new technologies seemingly emerging each day, many providers are struggling to select the most appropriate health...

Employing More Physician Assistants Reduces Healthcare Costs

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Adding more physician assistants to hospitalist care teams can lower healthcare costs while maintaining quality of care, a new study in the Journal of Clinical Outcomes Management contended. Researchers found that a hospitalist care team that...

How Broader Primary Care Teams Can Decrease Healthcare Costs

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Developing broader primary care teams that interact with specific patient populations can save healthcare costs and realize a return on investment, according to a recent PricewaterhouseCoopers (PwC) analysis. For example, a primary care team...

CMS: Rural Healthcare Faces Hospital Revenue Cycle Challenges

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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 Implementation Rules Affect Provider Profitability

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New value-based reimbursement models under the Quality Payment Program will launch on Jan. 1, 2017, leaving a couple of months for providers to educate themselves on MACRA implementation rules and prepare their practices for the shift. But taking...

GAO: Quality Measure Misalignment Impedes Provider Improvement

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Healthcare quality measures are integral to determining value-based reimbursement, but misalignment of quality measures across public and private payers has made it more difficult for providers to develop quality improvements for value-based...

AHA Calls for Hospital Access to Prescription Drug Rate Info

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The American Hospital Association (AHA) recently urged the Health Resources and Services Administration (HRSA) to grant hospitals in the 340B Drug Pricing Program more access to prescription drug rate information. In a comment letter on a proposed...

Hospitals Saw 23% Rise in Inpatient Prescription Drug Spending

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Hospital inpatient prescription drug spending has increased by 23.4 percent from 2013 to 2015, reported a recent study from the University of Chicago’s NORC. The increases in spending have left most providers struggling to manage their...

3M, Verily to Create Healthcare Revenue Cycle, Pop Health Tool

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3M Health Information Systems recently partnered with Verily Life Sciences to develop a technological platform that providers and payers can use to analyze population health measurements to better assess clinical and healthcare revenue cycle...

OIG Identifies Several Quality Improvement Challenges at IHS

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The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) recently identified several quality improvement challenges at Indian Health Services (IHS) hospitals, including access to care limitations, clinical incompetency,...

Black Book Names Optum360 Top HIM, Coding Outsourcing Vendor

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Optum360 earned the top spot for health information management (HIM) and computer-assisted coding outsourcing vendor among hospital chains, systems, corporations, and integrated delivery networks as well as independent inpatient facilities, according...

How Value-Based Reimbursement Affects Physician Productivity

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As payers push for more value-based reimbursement adoption, many healthcare organizations are wondering how to restructure physician productivity strategies to meet the unique requirements of performance-based payments. But the key to success...

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