Category: Revenue Cycle Management

lack-of-healthcare-interoperability-hinders-electronic-aco-reporting

Lack of Healthcare Interoperability Hinders Electronic ACO Reporting

CMS is looking to modernize the ACO reporting process by mandating the use of electronic clinical quality measures (eCQMs). However, accountable care organizations (ACOs) are concerned that the lack of healthcare interoperability will make electronic ACO reporting near impossible. “CMS must avoid making eCQMs mandatory until standard data fields exist across EHRs, and true interoperability […]
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aha-pens-oppositions-to-2022-physician-fee-schedule-proposed-rule

AHA Pens Oppositions to 2022 Physician Fee Schedule Proposed Rule

The organization is concerned about policies in the 2022 Physician Fee Schedule proposed rule, ranging from telehealth worries to apprehension about MIPS. The AHA agreed with certain aspects of the rule but also voiced various problems and recommendations for CMS to consider. The AHA opposed several telehealth policies that CMS included in the rule. The […]
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affordable-care-act-marketplace-sees-boost-in-diversity-savings

Affordable Care Act Marketplace Sees Boost in Diversity, Savings

HHS has announced that 2.8 million people gained health insurance coverage through the Affordable Care Act marketplace during the special enrollment period. This influx of enrollees raised marketplace enrollment to 12.2 million, the highest enrollment level that these marketplaces have ever seen. “It’s clear that when health coverage is accessible and affordable, people sign up, […]
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cms-repeals-rule-allowing-coverage-breakthrough-technologies-medicare-patients

The CMS repeals rule allowing coverage of breakthrough technologies for Medicare patients

CMS is exploring a new rule due to concerns raised and operational challenges. The rule that would have allowed access to Food and Drug Administration-designated and -approved technologies for Medicare patients suffering from illnesses and conditions that existing treatments and technologies are unable to address. CMS is exploring a new rule due to concerns raised […]
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5 Steps To Revenue Cycle Succession Planning Success

It’s more important than ever for revenue cycle leaders to think seriously about succession planning as baby boomers begin to retire and the revenue cycle increasingly requires more specialized skills, says PeaceHealth’s senior enterprise director of HIM, coding, and CDI. “Everyone’s replaceable,” says Cassi Birnbaum, senior enterprise director of HIM, coding, and CDI at PeaceHealth […]
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cms-to-tie-vaccine-mandate-to-medicaid-medicare-participation

CMS to Tie Vaccine Mandate to Medicaid, Medicare Participation

  A COVID-19 vaccine mandate for healthcare workers will be tied to Medicaid and Medicare Conditions of Participation (CoP), the Biden-Harris Administration recently announced. The announcement made via CMS yesterday said the Administration will require COVID-19 vaccination of staff in all Medicaid and Medicare-certified facilities by October. The emergency regulation, when it is released, will […]
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top-3-member-engagement-benefits-of-using-omnichannel-tools

Top 3 Member Engagement Benefits of Using Omnichannel Tools

Omnichannel strategies are becoming increasingly significant to successful member engagement. What is omnichannel engagement? Omnichannel engagement is a strategy that originated as a sales and marketing term but has infiltrated various sectors of the healthcare industry with the rise of healthcare consumerism. This strategy involves using various consumer touchpoints to push a product in a […]
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biden-administration-drug-plan-includes-value-based-payment-ideas-for-medicare

The Biden Administration Drug Plan Includes Value-Based Payment Ideas for Medicare

The administration said it would make the results of its drug price negotiations with manufacturers, as well as its approach to value-based care models, open to a variety of payers. The Biden administration Thursday released its plan to reduce prescription drug prices, which would include the use of models to test value-based payments in Medicare […]
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cms-provides-additional-arp-funding-states-promote-insurance-affordability

The CMS provides additional ARP funding to states to promote insurance affordability

The Centers for Medicare and Medicaid Services and the Biden Administration have earmarked $452 million in federal funding through the ARP  funding to Health insurance program for efforts to lower costs and improve health insurance access in 13 states. Due to the changes made to the ARP, states with 1332 reinsurance waivers will have more […]
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