Revenue Cycle Management Archives - Page 32 of 50

Key Quality Payment Program Changes in 2022 PFS Proposed Rule

CMS introduced the first seven MIPS value pathways and other updates to the Quality Payment Program as part of the Medicare Physician Fee Schedule proposed rule. If finalized, the Quality Payment Program (QPP) will undergo significant policy changes under the Medicare Physician Fee Schedule (PFS) proposed rule. Most notably, the rule introduced the first seven […]

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Payer Moves to Increase Member Access to Acute Home Healthcare

Regence BlueShield’s new partnership will offer members access to quality acute home healthcare services. Regence BlueShield (Regence) has partnered with a home healthcare provider to increase member access to acute home healthcare services. Regence members in Pierce County, Washington will have access to the new program. The payer plans to expand the acute home healthcare […]

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Telemedicine Use Higher Among PCPs with Value-Based Payment

A study of Medicare Advantage enrollees during the COVID-19 pandemic found that telemedicine use soared among primary care practices with value-based payment models. Telemedicine use skyrocketed among primary care practices during the pandemic, specifically for those with a value-based payment model, according to a research letter published in JAMA Health Forum. Many patients were forced […]

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Revenue Cycle KPIs Are Evolving as Automation Takes Hold

Leaders identified the number of days a claim sits in accounts receivable, the number of past due patient bills, and initial denials rates as top revenue cycle KPIs. The top revenue cycle key performance indicators (KPIs) are evolving as more organizations use automation to pinpoint high value operations to improve revenue cycle management, according to […]

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CMS Forecasts Increase in Dialysis Payment, Health Equity Gap Reduction

Proposed rule improves payment rates, incentives, and ESRD treatment choices. Disadvantaged Medicare patients suffer from end-stage renal disease (ESRD) at higher rates and are also more likely to be readmitted to hospitals, experience higher costs, and receive in-center hemodialysis when their kidneys are no longer able to function properly. Furthermore, non-white patients with ESRD are […]

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Despite Drop in Healthcare Mergers and Acquisitions, Revenue Rises

Analysis from Kaufman Hall reveals a historically low number of healthcare mergers and acquisitions in Q2, but revenue continues to rise. Healthcare merger and acquisition (M&A) activity was minimal in Q2, but total transacted revenue rose as health systems focused on acquiring smaller hospitals and strengthening regional partnerships, according to Kaufman Hall’s quarterly M&A report. […]

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4 Reasons Why UnitedHealthcare’s Attempt To ‘Monday Morning Quarterback ED Claims Is ‘Bad Policy’

“It really undermines what the physicians are doing at the point of care, and it’s bad policy,” says Doug Wolfe, co-founder and partner of the Miami-based law firm Wolfe Pincavage. UnitedHealthcare’s attempt to “Monday morning quarterback” emergency room visits by retroactively denying emergency claims is not only likely a violation of the prudent layperson standard, […]

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Biden administration aims to further rebuild ACA with proposed rule

It would lengthen the annual open enrollment period, expand the role of navigators and nix Trump-era guidelines for waivers that were criticized for allowing states to skirt coverage requirements. The Biden administration is planning to restore key parts of the Affordable Care Act that were pared back by the Trump administration as the current HHS […]

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CMS does not have enough authority to ensure hospital safety during pandemics, OIG says

Dive Brief: CMS does not have adequate authority to ensure that hospitals will be ready for the next pandemic, and wasn’t able to regulate them well enough to know whether they were maintaining quality and safety during the COVID-19 crisis, according to a new HHS Office of Inspector General report. As COVID-19 first emerged […]

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CMS Proposes $310M Boost, Value-Based Purchasing for Home Health

CMS has released a proposed rule for the Home Health Prospective Payment System in CY22, which aims to expand value-based purchasing and address health equity. CMS has released the proposed rule for the Home Health Prospective Payment System next year. The rule seeks to expand the Home Health Value-Based Purchasing (HHVBP) Model and address […]

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Category: Revenue Cycle Management

Key Quality Payment Program Changes in 2022 PFS Proposed Rule

Payer Moves to Increase Member Access to Acute Home Healthcare

Telemedicine Use Higher Among PCPs with Value-Based Payment

Revenue Cycle KPIs Are Evolving as Automation Takes Hold

CMS Forecasts Increase in Dialysis Payment, Health Equity Gap Reduction

Despite Drop in Healthcare Mergers and Acquisitions, Revenue Rises

4 Reasons Why UnitedHealthcare’s Attempt To ‘Monday Morning Quarterback ED Claims Is ‘Bad Policy’

Biden administration aims to further rebuild ACA with proposed rule

CMS does not have enough authority to ensure hospital safety during pandemics, OIG says

CMS Proposes $310M Boost, Value-Based Purchasing for Home Health

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