CMS wants to identify bad actors -– even if they are or have been affiliated with a legitimate provider. On Sept. 5, the Centers for Medicare & Medicaid Services (CMS) issued a new final rule. There was not really a proposed rule to which comments and suggestions could be made; there were Federal Register entries […]
Hospitals assuming downside financial risk under value-based care models is the key to lowering healthcare costs and improving quality, CMS believes. CMS Administrator Seema Verma urged hospitals on Tuesday to accept new value-based care models and price transparency requirements or face greater administrative burden, less competition, and lower reimbursement rates under Medicare for All. “Our choices are […]
Improving revenue cycle performance has become more challenging amid today’s healthcare payment trends and patient financial expectations. To gauge efforts at hospitals and health systems, Becker’s Hospital Review asked healthcare leaders to share changes their organizations have made to improve revenue cycle performance this year. Read their responses below, presented alphabetically. Venkat Bhamidipati Executive vice president and […]
Helping patients understand their financial responsibility and pay for services continues to be driven by an outdated and unnecessarily complex experience. Last year, three in 10 Americans had an unpaid healthcare bill go to collections. As more of the financial burden falls to patients with rising costs and an increase in high-deductible health plans, consumers are frustrated […]
HIV/AIDS payments, in particular, are under the microscope. The new Patient-Driven Payment Model, or PDPM, makes radical changes to the Medicare payment model for nursing homes. One of the largest changes is the reimbursement rate for services provided to HIV and AIDS patients. In 2016, there were 15,807 deaths among people with diagnosed HIV in […]
Providers are encouraged to file protective appeals. “In section XI of the preamble of the proposed rule, we discussed the growing number of Provider Reimbursement Review Board (PRRB) appeals made by providers and the action initiatives that are being implemented with the goal to decrease the number of appeals submitted; decrease the number of appeals […]
Several changes to the Merit-based Incentive Payment System (MIPS) track of the Quality Payment System (QPP) are outlined in a proposed rule for 2020 revisions to payment policies under the Physician Fee Schedule (PFS). Most of the proposed changes come as no surprise, but there is one proposal, in particular, that will make a huge impact on […]
Revenue cycle management technology is at the heart of the administrative side of business at every hospital and health system. It is key to daily operations. As such, healthcare CIOs and other IT professionals must take great care when implementing RCM systems. Getting revenue cycle done right – and done right the first time – […]
On Aug. 15, 1935, Will Rogers died in a plane crash near Point Barrow, Alaska. He is an Oklahoma legend and one of the best political satirists and commentators ever. I often wonder what his commentary would be on the state of U.S. politics in 2019. As an aside, Oklahoma City has two airports named […]
In the crowded healthcare market, smart healthcare leaders must find patient satisfaction advantages everywhere they can. When it comes to patient satisfaction, providing excellent clinical care is a no-brainer. But in a crowded and competitive healthcare market, smart healthcare leaders know that they need an edge everywhere, including an efficient revenue cycle. That’s the case […]