The final rules for fiscal year 2023 include a 3.8 percent payment increase for hospice providers, 2.5 percent increase for inpatient psychiatric facilities, and 3.2 percent boost for inpatient rehabilitation facilities. CMS has released final rules solidifying Medicare reimbursement rates for hospice providers, inpatient psychiatric facilities (IPFs), and inpatient rehabilitation facilities (IRFs) for fiscal year […]
When the Centers for Medicare & Medicaid Services (CMS) implemented the Patient Driven Payment Model (PDPM) as the new reimbursement method for skilled nursing facilities (SNF), some of us in the coding and auditing world thought it likely to result in inaccurate payments. The old model, the Resource Utilization Group—Version IV (RUGS-IV), calculated SNF reimbursement […]
The home- and community-based services quality measure set also aims to advance health equity and reduce health disparities for older adults and people with disabilities. CMS has released a quality measure set for home- and community-based services (HCBS), aiming to promote consistent quality measurement and data collection in the Medicaid HCBS program and improve health […]
Documenting a diagnosis in the health record extends beyond its impact on reimbursement and quality-of-care measures. It is also critical to patient safety. One of the more challenging aspects of the work as CDI professionals is physician engagement, which is why connecting the work to the patient level is so important. Many providers don’t want […]
“This will not only lower the cost of prescription drugs and health care for families, it will reduce the deficit and help fight inflation.” — President Biden, in a statement on health-care provisions in pending Senate bill, July 15 After months of negotiations, the president’s expansive “Build Back Better” plan has shrunk to a handful […]
A survey shows that 60% of consumers who look for pricing information seek answers from their insurance companies, but healthcare price transparency should still be a priority for providers. Not many consumers are asking how much healthcare services cost but among those who do, they are seeking answers primarily from their insurance companies, according to […]
Provider profit margins might increase after the COVID-19 pandemic based on three key shifts in payer mix and care delivery. Healthcare providers faced a rough couple of years as the COVID-19 pandemic dampened financial growth, but the post-pandemic future should create a favorable environment for provider profit margins, according to a new report. The report […]
More than 200,000 residents could be at risk of displacement if federal leaders establish minimum staffing requirements for nursing homes. Nursing homes would have to spend up to $10 billion per year and hire almost 188,000 nurses to comply with increased minimum staffing requirements, according to a report from the American Health Care Association (AHCA) […]
Lawmakers are also urging CMS to use its authority to adjust FY23 Medicare IPPS rates, to prevent net decreases. Medicare inpatient reimbursement cuts slated to take effect in the 2023 fiscal year would threaten access to care at hospitals, which are already facing substantially higher costs because of the ongoing COVID-19 pandemic, according to the […]
Health insurer reports second quarter numbers, boosted by performance of subsidiaries UnitedHealthcare and Optum Health. UnitedHealth Group reported a promising second quarter, achieving 13% revenue growth behind member expansion at UnitedHealthcare and value-based arrangements at Optum Health. The payer’s Q2 results were highlighted by revenue growing from $71.3 billion to $80.3 billion year-over-year, while earnings […]