Tag: RCM Services

electronic-payment-key-to-streamlining-healthcare-claims-management

Electronic Payment Key to Streamlining Healthcare Claims Management

The complexity around healthcare claims management is a major pain point for provider organizations, big and small. The increasing cost of claims coupled with a complex system of many payers, each with their own rules and requirements, creates administrative burdens and obstacles for providers. Ultimately, this complex system impacts the patient experience, as patients must […]
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how-the-affordable-care-act-impacted-small-group-coverage-trends

How The Affordable Care Act Impacted Small Group Coverage Trends

Small group coverage did not pursue the trends that many experts anticipated after the Affordable Care Act went into effect. From 2013 to 2020, small group coverage has maintained a fairly stable environment, researchers from the Urban Institute found. The researchers used the Medical Expenditure Panel Survey Insurance Component (MEPS-IC) in order to assess changes […]
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CMS COVID-19 Vaccination Rule

Centers for Medicare & Medicaid to Enforce Its COVID-19 Vaccination Rule, Sets New Deadlines

The Centers for Medicare & Medicaid Services (CMS) will enforce its COVID-19 vaccination requirement in 25 states, the District of Columbia, and other territories, according to an update released on December 28, 2021. CMS is enjoined from enforcing its COVID-19 vaccination rule in the other 25 states, which are involved in a case challenging its […]
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cms-updates-affordable-care-act-public-payer-enrollment-numbers

CMS Updates Affordable Care Act, Public Payer Enrollment Numbers

Affordable Care Act enrollment for 2022 and public payer enrollment midway through 2021 saw some record-breaking surges. In 2020 and 2021, public payer and Affordable Care Act marketplaces experienced major disruptions and changes that continue to have ripple effects. The year that the pandemic struck, Medicaid and CHIP enrollment escalated for the first time in […]
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medicare-advantage-consolidation-drove-healthcare-insurer-trends-2021

Medicare Advantage, consolidation drove healthcare insurer trends in 2021

  COVID-19 continued to affect the industry, which has plowed forward with expanded offerings, digital transformation and other bold moves. It was difficult to predict trend lines for the payer and health insurance industry in 2021, largely because of persistent uncertainties due to the COVID-19 pandemic. Consumer behavior has become more unpredictable, care models and […]
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physician-fee-schedule-final-rule-cy-2022

Physician Fee Schedule Final Rule for Calendar Year 2022 – CMS Cuts Rates and Extends Telehealth

On November 2, 2021, the Centers for Medicare and Medicaid Services (“CMS”) issued its Calendar Year (CY) 2022 Physician Fee Schedule (“PFS”) Final Rule. In this post, we sample some key highlights from the Final Rule. For more detail, take a look at our previous post, in which we highlight the PFS’s changes to the […]
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telehealth-key-takeaways-CY2022

Telehealth: Key Takeaways from The CY2022 PFS Final Rule

In November 2021, the Centers for Medicare and Medicaid Services (“CMS”) issued the Physician Fee Schedule Final Rule (“Final Rule”) which includes several telehealth policy updates that will go into effect in calendar year 2022.1  As a result of the COVID-19 public health emergency (“PHE”),  CMS expanded the availability of telehealth through the use of […]
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