The Impact of Accountable Care on the Revenue Cycle
Implementing value-based payment models requires changes to revenue cycle processes, including a greater focus on making sure claims reflect all services performed.
Ask the Experts: Medicare Adjustments During Appeals
Can we adjust a denied Medicare charge off of an account when an appeal is still open?
Developing a Specialty Medical Home Contract
University of Pittsburgh Medical Center gastroenterologists have teamed with UPMC Health Plan to develop a specialty medical home contract for patients with inflammatory bowel disease.
The Future of Healthcare Organizations Depends on Managing Medicare Costs
A healthcare thought leader explains the current Medicare payment system challenges and how CFOs can offset future Medicare cuts through cost containment.
Hospital Cuts in Trump Budget Called ‘Troubling’
Feb. 13—Adverse impacts from federal spending cuts were just one type of concern that hospital advocates raised this week about the Trump administration’s proposed budget.
Rising At-Risk Populations
Almost 84 million people out of a total population of 400 million, will be covered by Medicaid or Medicare by 2050.
Medicare Extenders and DSH Delay Face Uncertain Future
Feb. 6—Hospitals have faced a range of payment cuts since a regularly renewed package of Medicare funding lapsed at the end of 2017. But those cuts soon could be reversed.
CMS Offers Hospitals New Medicare Appeals Option
Feb. 6—A new settlement offer to resolve outstanding Medicare claims that have been denied on appeal is available for a limited time from the Centers for Medicare & Medicaid Services (CMS). The offer guarantees 62 cents on the dollar for claimed payment and payable on a faster timetable than previously available.
Proposal Calls for 1.84 Percent Rate Hike for 2019 Medicare Advantage Plans
Feb. 5—Medicare Advantage (MA) plans would receive a 1.84 percent pay boost in 2019 under a recently issued proposed call letter.
Observations About Value-Based Purchasing
The value-based purchasing (VBP) program established Centers for Medicare & Medicaid Services (CMS) requires redesign if it is to truly and effectively drive healthcare quality improvement.