Category: Healthcare News

Medicare Advantage

Medicare Advantage And The Future Of Value-Based Care

The Medicare Advantage (MA) program, which allows Medicare beneficiaries to voluntarily enroll in a private plan that administers health benefits, was established by the Balanced Budget Act (BBA) of 1997 as a vehicle to bring private-sector competition and innovation to Medicare beneficiaries. When the program was announced, the goal was to create greater competition on […]
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Artificial Intelligence in RCM

Using Artificial Intelligence To Advance Revenue Cycle Management

Artificial intelligence (AI) is making big waves in healthcare from detecting lung cancer and gene mutations that lead to autism to addressing social determinants of health and chronic conditions. The technology is automating and optimizing clinical workflows, leading to improved outcomes, lower costs, and enhanced patient and provider satisfaction. The critical role artificial intelligence now plays in healthcare prompting some providers to […]
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EHR

Is Your EHR Ready For PDGM?

When the Patient-Driven Groupings Model (PDGM) launches Jan. 1, 2020, leveraging tools and resources to ensure compliance will be critical to a successful transition. Home health care providers already have one helpful tool in place: the electronic health record (EHR). By incorporating workflow efficiencies, alerts, customizable features and feedback reporting capabilities, EHRs can provide visibility […]
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Allzone MACRA MIPS

Thinking Strategically About MACRA and MIPS: Will it Be Sink or Swim in 2019?

In Part One of this two-part article exploring the implications of MACRA for healthcare providers, healthcare leaders and health IT experts discuss why it’s critical for clinicians to think strategically, rather than tactically, about MACRA compliance. Numerous industry surveys have highlighted that U.S. physicians, by and large, remain unprepared for managing and executing Medicare Access […]
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Medicare Cards

The New Medicare Cards: What You Need to Know About Medicare Beneficiary Identifiers (MBIs)

To protect the privacy of Medicare recipients and prevent fraudulent use of Social Security Numbers (SSN), a new, unique 11-character Medicare Beneficiary Identifier (MBI) is replacing the SSN-based Health Insurance Claim Number (HICN) for Medicare transactions such as billing, eligibility status, and claim submissions. The MBI does not change Medicare benefits. What’s Behind The Change? The […]
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Medicare Advantage for Dual Eligibility

Medicare Advantage Dual Eligible’s Have Fewer ER Visits Than Those Under FFS

Dual eligible Medicare Advantage beneficiaries had 42.1% less emergency room visits than their fee-for-service counterparts. The cost of care and rate of hospitalizations for dual eligible Medicare Advantage (MA) beneficiaries was considerably lower than dual eligibles under fee-for-service (FFS), according to an Avalere Health study released Tuesday evening. Dual eligible Medicare Advantage (MA) populations averaged healthcare […]
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Surprise Medical Bills

Hospitals, Payers Must be Held Accountable For Surprise Medical Bills

President Donald Trump said it’s time for Congress to pass a law that stops hospitals and insurance companies from hitting patients with surprise medical bills. “We’re going to hold insurance companies and hospitals accountable,” Trump said during a news briefing Thursday. A bipartisan group of senators have been working on a bill addressing the issue, with the plan to […]
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