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

Reimbursement News

Bundled Payments Program Extended to Improve Value-Based Care


The Centers for Medicare & Medicaid Services (CMS) recently announced that some healthcare organizations can extend their participation in the Bundled Payments for Care Improvement (BPCI) initiative, a program that aims to increase value-based...

Accountable Care Organization Savings Shift After First Year


More than 700 accountable care organizations (ACO) currently work toward the goal of improving the quality of healthcare while also reducing capital costs of healthcare thanks to the Affordable Care Act. Meanwhile, researchers attempt to figure...

41% of Providers, Payers Adopt Value-Based Care Reimbursement


With the push from private and commercial health payers along with federal agencies to adopt value-based care reimbursement strategies, many more healthcare providers seem to have begun contracting through pay-for-performance arrangements. A...

Defining the Top 10 Terms of Healthcare Revenue Cycle Management


In some cases, definitions for terms and acronyms related to healthcare revenue cycle management can come across as fairly straightforward. Other times, they can sound more like a foreign language. A healthcare professional may find it difficult...

Healthcare Orgs to Review Healthcare Costs on Open Payments


According to a recent blog post, CMS is offering healthcare providers a chance to review and dispute healthcare costs related to manufacturers and group purchasing organizations, which will be published on the Open Payments data website on June...

New Primary Care Model Embraces Value-Based Reimbursement


This week, CMS announced its largest multi-payer initiative to improve primary care and introduce new value-based reimbursement models. The Comprehensive Primary Care Plus (CPC+) model aims to help practices transition from the “one-size-fits-all,...

6 Steps for Safeguarding the Healthcare Revenue Stream


With the ICD-10 conversion behind us, most billing and coding hiccups caused by the transition are slowly becoming a distant memory. However, rising patient out-of-pocket expenses – expected to reach $420 billion in 2015 – are just...

Healthcare Supply Chain Management Fraud Still Runs High


Despite a growing reliance on monitoring technologies to prevent fraud, healthcare organizations are still struggling to combat theft and abuse when it comes to supply chain management. According to a new survey from Deloitte Financial Advisory...

Affordable Care Act Increases Spending For Newly Insured


As the Affordable Care Act (ACA) brings more patients into the healthcare system, spending is on the rise, especially on chronic diseases, such as diabetes, heart disease and depression. Blue Cross Blue Shield (BCBS) backs this point in a recent...

Cancer Costs Don’t Rise Faster than Other Healthcare Spending


Cancer-related healthcare costs have increased at almost the same rate as non-cancer healthcare spending since 2004, according to a recent study by Milliman and the Community Oncology Alliance. The study counteracts the common misbelief that...

How Value-Based Care Payment Improves Patient Outcomes


Last month, the Centers for Medicare and Medicaid Services (CMS) released a new value-based care payment system for Medicare Part B drug prescribing protocols of physicians. Medicare Part B is a program in which decisions are reimbursed for prescribing...

Acquisitions, Scale Key to Pediatric Revenue Cycle Management


Stanford Children’s Health may be best known for delivering expert acute care to pediatric patients and expectant mothers at the flagship Lucile Packard Children’s Hospital, but inpatient services are only a part of how the system...

How to Scale Healthcare Bundled Payments throughout Hospitals


Healthcare bundled payments are a key strategy across the industry aimed at boosting patient health outcomes, improving the quality of care, and bringing reimbursement toward a value-based payment model. While the Centers for Medicare & Medicaid...

$628K Awarded to Boost US Healthcare Spending Research


The Peterson Center on Healthcare has awarded a $628,000 grant to the University of Washington’s Institute for Health Metrics and Evaluation (IHME) to analyze US healthcare spending and predict future spending trends, a recent statement...

4 Healthcare Supply Chain Management Tips for Revenue Success


In a healthcare organization, keeping tabs on the ebb and flow of medical supplies is an incredibly important yet often overlooked task.  From syringes and gauze to drugs, disinfectant, and paper gowns, understanding supply chain management...

What Does the Rise of Bundled Payments Mean For Providers?


One of the attributes of a sustainable value-based healthcare delivery system is payment based on the value of services delivered, instead of the volume-based fee-for-service model. Bundled payments have been explored for several years as an...

Patient-Centric Strategy Key for Value-Based Care Reimbursement


As is common in today’s healthcare industry, the move toward value-based care reimbursement has put a greater focus on patient satisfaction and engagement. Quality of care is intrinsically tied to superior health outcomes and patient satisfaction....

3 Change Management Strategies for Revenue Cycle Results


Healthcare consumers receive the highest quality of service when operational inefficiencies are reduced and business processes are aligned to the goal of that service. That’s true for consumers, but also for providers, third-party relationships,...

Provider Communication Key for Success in Bundled Payments


The Centers for Medicare & Medicaid Services (CMS) has established a number of different healthcare reimbursement strategies including pay-for-performance, alternative payment models, and bundled payments. For instance, the CMS Comprehensive...

Revenue Cycle Management Must Change for Community Hospitals


Community hospitals in Massachusetts will continue to close if they do not make appropriate changes to their revenue cycle management strategies, a study reveals. The study, released by the Health Policy Commission (HCP) in Massachusetts, shows...


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