For millions of Americans relying on Medicare, the specter of high out-of-pocket healthcare costs looms large. Unexpected illnesses, chronic conditions, and even routine medical needs can quickly erode savings and create significant financial strain. The idea of a Medicare out-of-pocket spending cap has long been a topic of discussion, promising a shield against catastrophic expenses. […]
In today’s complex healthcare environment, efficiency and cost control are critical for the financial health of providers, payers, and revenue cycle management (RCM) companies. One area that continues to experience inefficiencies is the claims management process—where errors, delays, and administrative overhead inflate operational costs. However, the rise of automation technologies is changing the game. Automating […]
2024 medicare part b premium: The Centers for Medicare and Medicaid Services have unveiled the premium rates, deductibles, and coinsurance figures for Medicare Part A and Part B in 2024, along with the income-based monthly adjustments for Medicare Part D in the same year. What is the Impact of 2024 Part B Premiums and Deductibles […]
Over 1,500 hospitals reviewed in the report were noncompliant with at least one requirement of the price transparency rule between December 2022 and January 2023. Less than a quarter of hospitals are complying with the hospital price transparency rule over two years after the regulation went into effect, according to a report from PatientRightsAdvocate.org. The […]
Value-based payment models, including accountable care organizations, bundled payment models, and capitation models, can generate savings for providers and limit healthcare spending. As healthcare spending escalates in the US, stakeholders have started looking at value-based payment models to address rising costs, but many payments are still tied to fee-for-service models, according to a Health Affairs […]
Almost a third of consumers cited inflation as their top reason for being concerned about covering unexpected healthcare costs. More than 70 million adults feel unprepared to pay for healthcare costs, while health systems are facing a tight labor market and ongoing supply chain issues, highlighting the financial repercussions of inflation in the healthcare industry. […]
The ED-ICU model has the potential to improve the value of healthcare delivery, as it has been shown to improve care quality and have little impact on emergency department costs. Total cost per emergency department (ED) patient encounter remained unchanged at an academic medical center after it implemented an emergency department-based intensive care unit (ED-ICU), […]
Supply chain issues, medication costs, and labor challenges sparked by the COVID-19 pandemic have contributed to the spiking hospital expenses. Hospital expenses have increased 23 percent since 2016, a spike researchers attributed to continuous COVID-19 challenges, according to a recent analysis. By analyzing American Hospital Association data, investigators noticed hospital expenses increased 47 percent in 2020when […]
Following a private equity acquisition, physician practices saw a 20.2 percent increase in charges per claim, an 11 percent raise in the allowed amount per claim, and a 37.9 percent increase in new patient visits. Private equity acquisition of physician practices in dermatology, gastroenterology, and ophthalmology was associated with increased healthcare spending and utilization, according […]
Another study confirms that medical billing costs in the US significantly exceed those in similar countries, but researchers now know why: coding drives up US administrative spending. Complex coding structures in the US are driving up medical billing costs in the US, making it one of the most expensive countries to get paid, according to […]