Revenue Cycle Management
The Congressional Budget Office has raised the specter that reform to the Medicare physician fee schedule statutory update formula could increase the likelihood that the ACA's Independent Payment Advisory Board mechanism would be triggered potentially resulting in as much as $0.6 billion in Medicare provider cuts.
A disconnect occurring in the fraud identification process used by CMS could mean that legitimate claims may be flagged as possible fraud.
Hard numbers for return on investment in health IT aren't always measurable, at least in a direct way. Instead, healthcare organizations need to look at both "hard" and "soft" savings when considering a system's ROI.
The next year will be a busy one for all involved in healthcare finance, between handling the influx of patients newly insured under the Affordable Care Act, the ICD-10 coding launch on Oct. 1, the continued proliferation of RAC audits and a variety of Medicare regulations.
In 2007, BCBS of Massachusetts asked Lowell General Hospital to accept a monthly capitated payment to care for its HMO members. The hospital simultaneously saw the potential and recognized the risks.
Business intelligence software can turn your life around - or ruin it. It all depends on how carefully you choose and how well you fold these tools into your overall strategic plan.
With the growing complexity and unpredictability of reimbursement, the existing back-end model of managing patients' payments is no longer sufficient. Hospital executives must focus on a proactive approach to collecting payment upfront as well as improving patient education.
Medical costs in commercial plans slowed between August 2012 and August 2013, according to the S&P Healthcare Claims Indices.
Maryland officials have reached what analysts say is an unprecedented deal to limit medical spending and abandon decades of expensively paying hospitals for each extra procedure they perform. If the plan works, Maryland hospitals will be financially rewarded for keeping people out of the hospital.
The California Department of Managed Health Care is trying to end the practice of emergency care "balance billing," just as thousands of new HMO members are being created.