Category: Revenue Cycle Management

Healthcare-Revenue-Goals-in-2022

Healthcare Revenue Goals Falling Short for Many Providers in 2022

Nearly half of CFOs and revenue cycle VPs in a recent survey said their organizations are behind their 2022 healthcare revenue goals. Most provider organizations are behind their 2022 healthcare revenue goals, according to a recent survey of health system and physician group finance leaders. Revenue cycle management technology vendor R1 RCM commission Census wide, […]
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Update on Medicare Reimbursement for ESRD facilitie image

Update on Medicare Reimbursement for ESRD facilities

The CY23 End-Stage Renal Disease (ESRD) Prospective Payment System Proposed Rule would increase Medicare reimbursement rates, among other policy changes. CMS recently proposed the Calendar Year 2023 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Proposed Rule, which would boost Medicare reimbursement for ESRD facilities and refine a new mandatory value-based purchasing program. The proposed […]
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Permanent Medicare Payment Adjustment for Home Health

Permanent Payment Adjustment for Home Health

The federal agency released the Home Health Prospective Payment System Rate Update proposed rule for CY23, which aims to permanently adjust Medicare payment based on PDGM. CMS proposes updated Medicare payment for home health agencies CMS is looking to apply a permanent prospective payment adjustment to the home health 30-day period payment rate to account […]
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Why Medicare’s trustees say the physician pay system is unsustainable

Medicare’s trustees have issued a report (PDF) that reckons with the consequences that patients could face as a result of the physician payment system’s long-term unsustainability. Your Powerful Ally The AMA helps physicians build a better future for medicine, advocating in the courts and on the Hill to remove obstacles to patient care and confront […]
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How Medicare Out-of-Pocket Healthcare Spending Cap May Impact Beneficiaries

How Medicare Out-of-Pocket Healthcare Spending Cap May Impact Beneficiaries

A Medicare out-of-pocket healthcare spending cap could halve out-of-pocket spending for beneficiaries, but could boost overall traditional Medicare spending. By implementing a $5,000 spending cap in traditional Medicare, policymakers might be able to halve out-of-pocket healthcare spending for high-spending Medicare beneficiaries, but they risk an increase in overall Medicare spending, a study from Urban Institute […]
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How physicians can untangle the web of relationships essential for value-based care success

How physicians can untangle the web of relationships essential for value-based care success

Primary care physicians (PCPs) and other physicians continue to migrate away from the traditional fee-for-service (FFS) reimbursement model toward value-based and risk-bearing care models that reward better outcomes and reduced healthcare costs. Value-based care (VBC) contracts are projected by McKinsey to cover nearly 65 million Americans, or 22% of insured lives, by 2025, up from […]
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No Surprises Act May Have Blocked 2M Surprise Billing Claims | AllZone Management Services Inc.

Healthcare spending could drop $11.4B next year if ACA premium subsidies expire, research finds

Healthcare spending could drop by more than $11.4 billion next year if enhanced premium tax credits enacted in the American Rescue Plan expire, new research finds. Hospital spending would decline by $3.8 billion, while spending on physician practice services would drop by $1.3 billion, according to a report from the Robert Wood Johnson Foundation and […]
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AMA says health insurance industry failing on prior auth reform

Survey shows little progress after four years of promises The American Medical Association says that despite insurance industry promises to reform and improve prior authorizations, little effort has been made to do so. This comes despite evidence that insurer-imposed authorizations can be hazardous and burdensome to patient-centered care. In January 2018, the AMA and other […]
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