Revenue Cycle Management

The number of people determined eligible for Medicaid since the launch of new insurance marketplaces is approaching 10 million, according to new data released from the Centers for Medicare & Medicaid Services.

Tenet Healthcare Corp., the nation's third largest for-profit hospital operator, said Tuesday it expects 15 percent of its uninsured patients to get covered this year as a result of the Affordable Care Act.

With the threat of significant reimbursement losses, hospitals and health systems are feeling the pressure of getting the transition to ICD-10 right.

The recent delay of the employer mandate for medium-sized businesses will harm not-for-profit hospitals because it postpones increased revenues from expanded coverage of previously uninsured patients and the subsequent reduction in bad debt and charity care it would bring, a Moody's report said.

Because health system operators reacted quickly to manage payment cuts and lower patient volumes, Moody's Investors Service has upgraded its for-profit hospital outlook to positive from stable.

Conventional wisdom says that too many ICD-10 codes will make it harder for clinicians and medical coders to do their jobs. Some studies suggest a 50 percent or more drop in productivity. But is this an underestimation of the problem?

A newly released update to the landmark 2008 Nachimson study says two-thirds of practices would fall in the upper range of implementation cost projections.

Predictive analytics is becoming an important part of the revenue cycle in hospitals in the effort to deliver higher quality care at lower cost.

The hospital company said the controversial “two-midnight” rule, which took effect during Q4, did have a negative impact on admissions metrics, but revenue per equivalent admission increased 4.8 percent on a same facility basis.

Hospitals can take a deep breath, and rest easier for at least six months. CMS is delaying enforcement of its "two-midnight" policy until after Sept. 30.