Tag: Revenue Cycle Management

key-quality-payment-program-changes-in-2022-pfs-proposed-rule

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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cms-forecasts-increase-in-dialysis-payment

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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Rethink ACO Financial Risk Advancement in MSSP

AMGA expressed some concerns following CMS’ decision to extend its postponement policy regarding ACO financial risk advancement in the Medicare Shared Savings Program. The American Medical Group Association (AMGA) recommended several steps regarding accountable care organization (ACO) financial risk advancement in the Medicare Shared Savings Program (MSSP) in a letter to CMS. CMS’ decision to […]
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AHA’s Recommendations for Inpatient Medicare Reimbursement in FY22

AHA urges CMS to reassess inpatient Medicare reimbursement for organ acquisition and modify the distribution of residency slots as part of the FY 2022 IPPS proposed rule. The American Hospital Association (AHA) released comments on CMS’s FY 2022 Inpatient Prospective Payment System (IPPS) proposed rule, which would increase inpatient Medicare reimbursement rates by $2.5 billion. […]
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how-to-increase-provider-utilization-of-remote-patient-monitoring

How to Increase Provider Utilization of Remote Patient Monitoring

Increasing provider utilization in remote patient monitoring starts with effective backend processes and leaning into technologies that they already trust. Remote patient monitoring (RPM) took off during the coronavirus pandemic, but the industry will have to take decisive steps in order to build on that momentum, according to Eric Wicklund, senior editor of mHealthIntelligence. Remote […]
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