Category: Blog

Challenges Facing the Healthcare Industry

5 Major Challenges Facing the Healthcare Industry In 2019

Healthcare is facing rapid changes. Here’s what you need to know to stay ahead in 2019 and beyond. The healthcare industry is facing many changes that pose new challenges to healthcare organizations big and small. In particular, the fast-evolving government regulations, technological innovations, and patient expectations create a new environment in which running a medical […]
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CMS Finalizes 2018 MPFS Payment and Policy Changes - Allzone

Most Hospitals Will See Positive Payments in 2019

U.S. hospitals that are putting quality over quantity will fare well next year for their efforts. Out of  approximately 2,800 hospitals across the country, more than 1,550 will see an increase in their 2019 Medicare payments. For the rest? Well, the news isn’t so good. Where Does The Money Come From? The Centers for Medicare […]
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Maximizing Medicaid Expansion Benefits

Three more states voted in this previous election to expand Medicaid. Virginia will be going forward with Medicaid expansion on January 1, 2019. Though Medicaid reimburses you at a very low rate, they will pay more than most self-pay patients and the cost to collect is much lower. The payer mix shifting from uninsured to […]
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Trump To Let States Divert Obamacare Funds To Other Health Plans

The Trump administration plans to allow states to direct billions of dollars of Obamacare subsidies to health plans that don’t meet the law’s requirements. Critics contend the new policy could undermine the ACA by driving up costs for some individuals. The change is intended to make insurance more affordable and expand consumer choice. Premiums for […]
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ICD-10 Coding: New Character Surfaces in Spinal Fusion Codes

Are there “Zs” in your spinal fusion coding? The fiscal year (FY) 2019 ICD-10-PCS updated an area that has not received much attention: Spinal fusion codes. During the Centers for Medicare & Medicaid Services (CMS) Coordination and Maintenance Committee meeting in September 2017, the topic of invalid spinal fusion codes was raised. There were spinal […]
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CMS to Launch Artificial Intelligence Health Outcomes Challenge

CMS is teasing a new cross-industry challenge to identify innovative strategies for using artificial intelligence to improve health outcomes. The CMS Innovation Center is gearing up to launch a new industry challenge aimed at identifying new strategies for leveraging artificial intelligence and machine learning to improve outcomes. The proposed challenge will explore how artificial intelligence […]
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2019 Physician Fee Schedule: Big Changes Ahead

No separate codes for podiatric E&M visits in final rule. The final rule for the 2019 Physician Fee Schedule was released on Nov. 1. Some of what was in the proposed rule was finalized, while other elements were either modified or completely eliminated. The proposal to reduce payment when evaluation and management (E&M) office and […]
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Mcare Appeals

Court Orders HHS to Eliminate Medicare Appeals Backlog by 2022

In light of new funding from Congress, HHS must reduce the Medicare appeals backlog according to annual deadlines and percentage amounts, a judge ordered. HHS must eliminate the Medicare appeals backlog at the Administrative Law Judge (ALJ) level by the end of the 2022 fiscal year, according to a recent court order. Judge James E. […]
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