Reimbursement

Reimbursement

Nov 13 | Susan Morse

CMS expands mental health payment for residential services

CMS letter to state Medicaid directors outlines new federal waiver to get reimbursed for residential treatment services.

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Nov 13 | Beth Jones Sanborn

How St. Luke's created a patient-centric revenue cycle to improve satisfaction and collections

Case study: Revised paper statements and new digital patient portal drove a 38% improvement in…

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Nov 12 | Susan Morse

CMS proposes changes to streamline managed Medicaid

Proposed changes include rate range flexibility and adding new delivery models such as telehealth.

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Nov 09 | Jeff Lagasse

Healthcare cost variations between regions attributed to price, usage

Colorado has the highest prices in the six regions studied, while Maryland came in well below the average.

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Nov 09 | Susan Morse

How health insurance companies use AI to make consumers healthier

Insurers are using artificial intelligence and machine learning to review medical records, optimize care for people with…

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Nov 08 | Susan Morse

Health and Human Services issues rule to deny contraception coverage based on religious, moral grounds

The law leaves in place government programs that provide free or subsidized…

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Nov 07 | Jeff Lagasse

Implications of the repeal of the individual mandate on uncompensated care audits -- and what to do

With the mandate repealed, and DSH dollars unchanged, competition for that money is going…

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Nov 07 | Beth Jones Sanborn

Open enrollment initial numbers show first three days yielded more than 371,600 plan selections

Since enrollment weeks are measured Sunday through Saturday, these first figures account for…

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Nov 06 | Susan Morse

Medicaid expansion in five states rests on hotly contested gubernatorial elections

In Maine, which represents a sixth closely-watched race for governor, the question of expansion heads to…

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Nov 06 | Susan Morse

CVS expects deal with Aetna to close by Thanksgiving

CVS profits in Q3 decreased 5.8 percent to $2.4 billion, driven by a $64 million increase in acquisition-related transaction and…

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Featured Resources

Care Collaboration Success for Improved Outcomes The nature of our healthcare ecosystem has been one of siloed care. Rarely do payers, providers and local resources come together with the patient's well-being prioritized as a unifying mission. Read how these organizations are getting it right.

Debunk the Myth: Outsourcing Doesn't Mean Losing Control With shifts in payer mixes and reimbursement structure, the margin of reimbursement has been shrinking steadily over the last five years. How do revenue cycle leaders navigate payment reform while maintaining stable business office operations?

Beyond Dollars and Cents: A Closer Look At Value Beyond the expected improvement in specific metrics, many organizations that outsource RCM with a trusted and certified partner are seeing several ancillary benefits of such agreements.

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Nurses with a bachelor's degree boost patient safety

News

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. ...

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.

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.

Whitepapers

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 report ...

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 ...

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.

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