Reimbursement
A 25 percent cut in the Medicare physician payment rate, driven by the "sustainable growth rate" formula, looms Jan. 1 unless Congress takes action to avert. The American Medical Association's president believes a permanent solution is on the horizon.
Defensive medicine has contributed to the rising cost of healthcare in the U.S. But two recent reports suggest the true scope of the problem may be somewhat exaggerated, and the solution not too complex.
More than 75 percent of healthcare costs are due to chronic conditions. Although chronic diseases are more common among older adults, they affect people of all ages and are now recognized as a leading national health concern. While we know that chronic disease is most effectively managed through frequent, near-continuous monitoring, there are pervasive problems with the quality of chronic disease care.
Accountable care organizations (ACOs) may actually be the unicorns we've been waiting for, spreading their cost-saving magic throughout the health system.
The CEO of Mobile Doctors, a Chicago-based service offering house calls in six states, was arrested on charges of fraudulently overbilling Medicare. One of the company's physicians was also arrested for making false statements about health benefits.
Federal agents seized up to $2.6 million in fraud proceeds from various bank accounts held by the Chicago-based firm, which specializes in physician house calls across six states. The company is accused of upcoding Medicare bills for in-home patient visits.
The healthcare cooperative in Arizona is preparing to sell 30 different health plans through the insurance exchange this fall, after it was rebranded earlier this summer.
State-of-the-art revenue cycle technologies can not only speed up the claims submission and payment process, but also make the lives of business office staff much easier. Here are 4 key technologies that help providers collect what they're owed.
The North Carolina Department of Health and Human Services' website will soon publish the prices of the 140 most common in-patient, surgical and imaging services performed by every hospital in the state.
Pennsylvania healthcare organizations Highmark and UPMC have been litigating for some time, amid a contract set to end in 2014, and now a series of advertising campaigns has brought the governor into the debate.