Topics
Reimbursement
Volume growth contributes to improved hospital margins in October, finds Kaufman Hall
Hospital margins up in October, driven by volume
Revenue Cycle Management
Referral process going digital as healthcare providers look to stem revenue leakage
Referral processes going digital
Strategic Planning
Machine learning, AI, telemedicine and other technologies will pose data security risks, says Dr. John Halamka
New tech will create data security risks
Capital Finance
Healthcare real estate: The pros and cons of buying versus leasing
To lease or to buy? The pros and cons
Supply Chain
Unnecessary healthcare supply chain spending reaches almost $26 billion; savings opportunities remain
Unnecessary supply chain spending reaches $26B
Accounting & Financial Management
Healthcare spending rises to $3.6 trillion in the U.S., driven partly by health insurance tax
Health spending rises to $3.6T
Budgeting
'Care cascades,' or unwarranted tests, show hidden costs
Unnecessary tests show hidden costs
Quality and Safety
Hospitals given latitude to select transplant candidates don't prioritize sickest patients
Hospitals don't prioritize sickest transplant candidates
Billing and Collections
Poor digital billing process associated with uncollected payments
Poor digital billing associated with collections
Claims Processing
BCBS Institute and Solera partner, pay SDoH organizations through outcomes-based medical claims
BCBS Institute, Solera, to pay organizations through outcomes-based claims
Workforce
Job opportunities for physicians increase by 5% as demand surges, though worries about a shortage remain
Physician job opportunities increase 5%
Operations
Getting a handle on identity and access in healthcare isn't just a technology problem
Identity and access: Not just a tech problem
Medical Devices
Apple is developing custom health information tracking chips
Apple is developing custom health chips
Hospital/physician relations
Quality of initial training makes a big difference in EHR satisfaction, KLAS report finds
Poor EHR training brings down provider satisfaction
Construction & Facilities Management
Cape Cod Healthcare building $180M patient tower, investing in EHR
CCHC building $180M patient tower
Compliance & Legal
Ten former NFL players charged with alleged fraud of healthcare benefit program for retired players
Ten former NFL players charged with fraud
Policy and Legislation
Republican satisfaction with U.S. healthcare costs is on the upswing, finds Gallup
GOP satisfaction with health costs on upswing
Community Benefit
Advocate Aurora Health contributed $2.1 billion to community charitable care and services in 2018
Advocate Aurora: $2.1B in charity care
Accountable Care
Physician-led accountable care organizations outperform hospital-led counterparts
Physician-led ACOs outperform hospital ACOs
Acute Care
Pressure ulcers cost the health system $26.8 billion a year
Pressure ulcers cost the health system $26.8B a year
Ambulatory Care
Medical schools, teaching hospitals account for 3% of US GDP, report shows
Med schools, teaching hospitals are 3% of GDP
Analytics
Anthem, MassChallenge HealthTech to collaborate on accelerator launch
Anthem, MassChallenge HealthTech launching accelerator
Business Intelligence
While the price of healthcare is growing, utilization is dropping and price variations persist, report says
HCCI: Price of healthcare is growing, utilization is dropping, price variations persist
ICD-10 & Coding
Physician practices examine risk adjustment coding in wake of federal lawsuits
Practices keeping close watch on risk adjustment coding
Meaningful Use
CMS overhauls meaningful use EHR program, renames it 'Promoting Interoperability'
CMS overhauls meaningful use as 'Promoting Interoperability'
Medicare & Medicaid
Final days of ACA open enrollment show 10% drop in signups
ACA enrollment down 10% going into final days
Patient Engagement
Millennials, Gen Xers less satisfied with health plans, new survey shows
Younger consumers are less satisfied with health plans
Pharmacy
Suicide attempts and hospitals admissions linked to non-opioid drugs on the rise
Suicides, admissions linked to non-opioid drugs
Population Health
Majority of parents say socioeconomic factors negatively impact their families' health
Socioeconomic factors impact families' health
Risk Management
Cybersecurity needs to be put in business terms
Cybersecurity needs to be put in business terms
Telehealth
Roper St. Francis Healthcare launches multi-hospital tele-ICU initiative with Advanced ICU Care
Roper St. Francis launches multi-hospital tele-ICU initiative
Mergers & Acquisitions
CVS Health to acquire IlliniCare Health in agreement with Centene
CVS to acquire IlliniCare in Centene deal
View more

Medicare Administrative Contractors (MACs)

In-depth

CMS revamps the Medicare program integrity manual to accelerate innovation, access to technology

CMS revamps the Medicare program integrity manual to accelerate innovation, access to technology

Reforms to the local coverage determination process will…

CMS relents, opens up smartphone-connected CGMs for reimbursement

CMS relents, opens up smartphone-connected CGMs for reimbursement

The Centers for Medicare and Medicaid Services will reverse a longstanding unpopular position…

Whitepapers

Three Data-Driven Processes for Maximizing Healthcare Revenue

Three Data-Driven Processes for Maximizing Healthcare Revenue

Over the past decade, changes in the healthcare landscape have squeezed margins, brought…

The State of Healthcare Performance Improvement

The State of Healthcare Performance Improvement

Kaufman Hall has released its third annual survey of hospital and health system leaders on the state of…

Latest News

October 3, 2018 | Susan Morse

CMS revamps the Medicare program integrity manual to accelerate innovation, access to technology

June 15, 2018 | Jonah Comstock

CMS relents, opens up smartphone-connected CGMs for reimbursement

May 2, 2018 | Susan Morse

HHS Secretary Alex Azar to Supreme Court: Time to rule on Medicare case that affects $4 billion

March 26, 2018 | Beth Jones Sanborn

Medicare overpaid $367 million for outpatient physical therapy in six-month stretch, OIG audit finds

November 28, 2016 | Beth Jones Sanborn

Two Midnight rule helped slash improper payments for inpatient hospital claims by 58 percent, CMS says

June 9, 2016 | Susan Morse

CMS delays review of short stay patient claims under two midnight rule

November 2, 2015 | Susan Morse

CMS cements 'physician judgment' exception in two-midnight policy

VIEW ALL NEWS

MostPopular

Former Aetna CEO Mark Bertolini talks about insurers staying relevant

Former Aetna CEO Mark Bertolini talks about insurers staying relevant

Optum: UnitedHealth's secret weapon

Optum: UnitedHealth's secret weapon

List: 769 hospitals fined for medical errors, infections

List: 769 hospitals fined for medical errors, infections

UPDATED: List of 2020 Medicare Advantage star ratings

UPDATED: List of 2020 Medicare Advantage star ratings

See the first star ratings for home health

See the first star ratings for home health

Emerging employee wellness trends for 2020

Emerging employee wellness trends for 2020

List: CMS 2019 Star ratings show Kaiser on top

List: CMS 2019 Star ratings show Kaiser on top

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Healthcare mergers and acquisitions in 2016: Running list

Healthcare mergers and acquisitions in 2016: Running list

While 2015 was a record-breaking year in healthcare mergers and acquisitions, 2016 saw more change as organizations across the industry adjust and adapt to the evolving financial landscape.

Analyze this: Health systems, health plans get to the core of big data

Analyze this: Health systems, health plans get to the core of big data

Pamela Peele knows that people who subscribe to cooking magazines have a much higher risk of going to the emergency room. But how she knows that is a whole other story.

Once-failing hospitals say accountability, transparency key to surviving fallout from failing patient safety grades

Once-failing hospitals say accountability, transparency key to surviving fallout from failing patient safety grades

When Leapfrog released their Spring 2016 patient safety grades recently, 15 hospitals got slapped with a very public 'F' grade casting a spotlight on them that no institution wants. But with more patients weighing public hospital grades, experts, as well as a few…

Whitepapers

Credible, Defensible Estimates

Credible, Defensible Estimates

In healthcare, every interaction with the patient matters. Especially in today's environment of continuous improvement, efforts have been concentrated on coordination among providers, the patient care experience and quality outcomes - all laudable goals.

Clinical Quality Measures 101

Clinical Quality Measures 101

Although quality-reporting programs such as meaningful use provide incentives to help providers implement and use electronic health records (EHRs) to collect and report on clinical data, practices often need help deciding what data to collect, which measures to…

Gaining Actionable Insight into Financial Systems and Areas Impacting the Revenue Cycle

Gaining Actionable Insight into Financial Systems and Areas Impacting the Revenue Cycle

Hospital systems across the country are looking to streamline their billing and collection processes to become more efficient and better compete in their markets. The challenge many face is how to turn the data that's already flowing through financial systems into…