Category: Revenue Cycle Management

Permanent 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

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

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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Healthcare Finance Leaders Facing Revenue Cycle Workforce Shortages

Healthcare Finance Leaders Facing Revenue Cycle Workforce Shortages

More than 400 healthcare finance leaders reported having revenue cycle workforce shortages, with almost 20 percent seeing 30 or more vacancies. Healthcare finance leaders are experiencing revenue cycle workforce shortages, with one in four reporting that they need to hire more than 20 employees to fully staff their department, according to a survey commissioned by […]
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5 Benefits of Addressing Payment Integrity Before Payments Are Ever Made

5 Benefits of Addressing Payment Integrity Before Payments Are Ever Made

Payment integrity in Medicaid—the concerted effort to keep tight control over fraud, waste and abuse—can be addressed at any stage in the claim cycle. Of course, the earlier it is addressed, the easier it is for health plans to avoid improper payments and the administrative burden of recovering them. And while pre-payment integrity programs maximize […]
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CMS Issues Contract Year 2023 Final Rule for Medicare Advantage Organizations and Prescription Drug Sponsors

CMS Issues Contract Year 2023 Final Rule for Medicare Advantage Organizations and Prescription Drug Sponsors

  On April 29, 2022, the Centers for Medicare and Medicaid Services (“CMS”), issued the final rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Final Rule”).  CMS promotes the Final Rule as advancing “CMS’ strategic vision of expanding access to affordable health care […]
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What is the HIPAA Security Rule?

What is the HIPAA Security Rule?

The HIPAA Security Rule requires covered entities and business associates to implement technical, physical, and administrative safeguards. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) required the HHS secretary to develop rules for safeguarding electronic protected health information (ePHI). Out of these requirements, HHS created the HIPAA Privacy Rule and the HIPAA Security […]
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