CMS has released the proposed rules for the Inpatient Rehabilitation Facility (IRF) Prospective Payment System and the Inpatient Psychiatric Facility Prospective Payment System for fiscal year (FY) 2022. Issued yesterday, the proposed FY 2022 IRF Prospective Payment System rule would increase Medicare payments by 1.8 percent, or $160 million, compared to the previous fiscal year. The […]
Despite the strain placed on physicians by the COVID-19 pandemic, insurers continued to impose prior authorization requirements which delayed care and hurt some patients. According to a news release from the American Medical Association (AMA), a new survey showed that nearly 70 percent of the 1,000 respondents showed that health insurers had either reverted to prior authorization […]
CMS is temporarily holding claims from providers in anticipation of legislation that will extend the suspension of the 2 percent Medicare sequester, according to a recent newsletter. The MLN Connects newsletter from March 30 stated that CMS has “instructed the Medicare Administrative Contractors (MACs) to hold all claims with dates of service on or after April […]
Electronic Prior Authorization can have a positive impact for both physicians and patients. America’s Health Insurance Plans (AHIP) published a news release stating that an analysis of the E-prior authorization process found that it was able to significantly reduce the time between a request for authorization and a decision and the time between the […]
Price transparency, increasing revenue, and reducing denials are three of the revenue cycle’s thorniest issues. At the HealthLeaders Revenue Cycle Ideas Exchange in mid-March revenue cycle leaders from the nation’s top health systems shared their proven strategies for success for each of these problems. Here’s what they had to say. Although root cause data showed that 47% of […]
Given the current state of the world, AI is expected to play a critical role in home-based care systems, particularly in the areas of data collection, monitoring, analysis, and interpretation. The increase in the number of monitoring devices such as fitness trackers and wearable technology, for example, demonstrates the effect of AI on home […]
The world is changing and the operations behind healthcare reimbursement is changing with it. Healthcare organizations are recovering from an unprecedented public health crisis during which entire service lines shut down so providers could focus on stopping the spread of a deadly virus. Meanwhile, healthcare has been going through a digital revolution. The clinical shift […]
Healthcare consumerism is on the rise , as patients report the desire to use telehealth and contactless payment options post-COVID-19. However there are disconnects between payer, provider, and consumer expectations, according to the eleventh annual Trends in Healthcare Payments Report from InstaMed. The report explores how COVID-19 has accelerated many trends that have improved the consumer experience […]
Today the Biden Administration announced its latest group of appointments to the Department of Health and Human Services. The new appointees join tens of thousands of career officials throughout the agency at a time when expertise is critical to tackling the ongoing COVID-19 pandemic. WHAT’S THE IMPACT? Kristina Schake will serve as HHS Secretary Xavier Becerra’s […]
A cost-cutting change in Medicare policy will reduce payments to hospitals for some surgical procedures and increase costs for patients, according to a March 21 report from the The Washington Post. Before the change, CMS categorized 1,740 surgeries and other services as eligible for Medicare payments only if they were performed on beneficiaries who were admitted […]