Industry News

As Patient Responsibility Jumps 29%, Providers to Focus on Patient-Centric Payment Solutions

October 25, 2017,   Healthcare Finance News
It's a new era of patient payment technology that requires more financing options, engaging patients early, analyzing consumers' propensity to pay, managing expectations and achieving true cost transparency. Those are the broad findings from Black Book's new 2017 Revenue Cycle Management Surveys, based on a research study designed to track consumer satisfaction and patient experience trends, as well as uncover payment challenges and strategies for healthcare provider organizations.
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States' Lawsuit to Continue Cost-Sharing Payments Faces a Challenging Road

October 16, 2017,   Modern Healthcare
Attorney generals in 19 states face a tough battle to convince a federal judge that the Trump administration is legally obligated to fund cost-sharing subsidies to insurers.
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New Data Deadline for $2.3 Billion Payment Shift

October 9, 2017,   HFMA
Industry advisers are urging hospitals to double-check their charity care reporting this month in preparation for a major Medicare charity care policy change that is expected to shift the distribution of $2.3 billion annually among hospitals.
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CMS Seeks New Payment Model Direction

September 26, 2017,   HFMA
The Centers for Medicare and Medicaid Services (CMS) last week released a Request for Information (RFI) signaling a willingness to further explore or even change the alternative payment models the Obama Administration had employed to reduce Medicare costs and improve quality of care and patient safety.
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Single-Insurer Counties Surge to 50 Percent for 2018

September 20, 2017,   HFMA
The share of government-run insurance marketplaces projected to have just one insurer jumped to nearly 50 percent nationwide, according to the Centers for Medicare & Medicaid Services (CMS).
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Medicare Shared-Savings ACOs Cut $1 Billion in Costs Over Three Years

August 29, 2017,   Modern Healthcare
Accountable care organizations participating in the CMS' Medicare shared-savings program reduced spending by about $1 billion in three years, HHS' Office of Inspector General reported Tuesday.Most of the 428 ACOs in the first three years of the shared-savings program reduced Medicare spending compared to their benchmarks, and a small group of those ACOs produced "substantial" savings.
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Physician Offices, Hospitals Still Trying to Prepare for MACRA's Reimbursement Changes

August 26, 2017,   Modern Healthcare
More than halfway through the first year of the rollout of the Medicare Access and CHIP Reauthorization Act, fewer than 1 in 4 physicians interviewed for a recent American Medical Association study said they were prepared to meet statutory requirements this year. The revelation could mean that many will face a financial penalty in 2019, which is when 2017 compliance will be monetarily enforced.
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CMS Will Cancel Major Bundled Payment Initiatives

August 14, 2017,   Hospital CFO Report
CMS has proposed canceling the cardiac and expanded joint replacement bundled payment models. The rule, which was sent to the Office of Management and Budget last week, would cancel the mandatory bundled payment programs for heart attacks and bypass surgeries as well as expansion of the existing Comprehensive Care for Joint Replacement model to include surgical treatments for hip and femur fractures.
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Blockchain Eyed For Potential Use Cases in Revenue Cycle

August 2, 2017,   Healthcare Finance News
Payers are sizing up ledger tech for payments and claims processing, but one big area of growth could be next-generation personal health records.
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US News Delays Hospital Rankings to Fix Data Problems

July 18, 2017,   Becker's Hospital Review
U.S News & World Report will delay the release of its 2017-18 Best Hospitals rankings to Aug. 8 after researchers discovered errors in the data used to compile the rankings. The rankings were to be published Aug. 1. However, researchers uncovered errors requiring the rankings to be reassessed, officials said in a statement on the publication's website.
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Healthcare Pricing Falls to Lowest Growth Rate in a Year

July 17, 2017,   Modern Healthcare
Hospital cost-cutting and competition have caused healthcare prices to slip to their lowest rate of growth in a year, according to a new report from the Altarum Institute.
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Data Points: ACOs Keep Evolving, Now Covering 10% of U.S. Population

July 15, 2017,   Modern Healthcare
Hailed as one of the primary vehicles for driving the industry away from fee-for-service arrangements, accountable care organizations now cover roughly 10% of the U.S. population, according to Leavitt Partners and the Accountable Care Learning Collaborative. The groups found that 923 public and private ACOs were operating nationwide as of March 31.
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43% of C-Suite Execs Name Cybersecurity as No. 1 Operational Challenge

July 14, 2017,   Becker's Hospital Review
The majority of C-suite executives (85 percent) agree cyberattacks will become more frequent and more costly, according to a global survey by the management consulting firm A.T. Kearney.
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Hospitals Handling Growing Debt Loads — For Now

June 22, 2017,   Modern Healthcare
Hospital borrowing has the debt markets booming.Whether that's the case a year from now is anyone's guess. Although efforts to replace elements of the Affordable Care Act will likely come to a head this week, 2018 won't be without its share of uncertainty.
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300+ Hospital Executives Tell Their No. 1 Financial Strategy

June 19, 2017,   Becker's Hospital Review
Hospitals cited "reviewing and optimizing current operational and clinical processes" as their top strategy for containing costs in the next three years, according to a survey of U.S. hospital executives. The survey, conducted by Economist Intelligence Unit and sponsored by Prudential Retirement, took place last January and February. More than 300 hospital executives participated.
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Hospitals Work to Harness the Power of Digital Marketing

June 5, 2017,   Modern Healthcare
Ascension's advertising has taken a decidedly digital turn as the Catholic giant rebrands all of its facilities. St. Louis-based Ascension joins many other health systems that are moving more of their marketing budgets to digital and away from traditional media because that's where consumers are going first to research their conditions and providers, marketing executives say.
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Healthcare Providers Make Up Big Slice of Forbes 'Best Employers' List

May 11, 2017,   Healthcare Finance News
It seems hospitals and health systems are pretty good places to work. That's one of the takeaways from Forbes' annual list of America's Best Employers, as healthcare organizations nabbed 25 out of the top 100 slots in the large employer category - a full 25 percent, better than the other industries that were represented on the list.
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Engaging With Patients to Keep Them Happy and Healthy

May 11, 2017,   Modern Healthcare
“U up?” No, it's not a text from a paramour. Instead, it's the opening line from one of Healthgrades' chatbots. They conduct automated conversations with patients, checking in about their health in between physician appointments.
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VA May Close 1,100 Facilities to Privatize More Veterans Healthcare

May 5, 2017,   Healthcare Finance News
The Department of Veterans Affairs is considering closing over 1,165 of its facilities as part of its plans to let more veterans receive medical care in the private sector, VA Secretary David Shulkin, MD, told U.S. House of Representatives Committee on Appropriations on Wednesday.
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Despite Cutting Readmissions, HRRP Penalties Hit Some Hospitals More

May 3, 2017,   Healthcare Finance News
Since its implementation in 2010, evidence shows the Hospital Readmission Reduction Program cut reduced hospital readmissions for certain conditions, as was the program's intent. A new Health Affairs study, however, indicates the current penalty structure leads some hospitals to be penalized persistently, leading to a financial burden.
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As Patients Take Hospital Bill Issues Public, Hospitals Take Stock of Their Practices

May 2, 2017,   Healthcare Finance News
A hospital bill can be a complicated endeavor for a patient, prompting a backlash if it's not easily decodable. Recently, four hospital systems in Colorado - Centura Health, Health One, SCL Health and UCHealth - found themselves on the defensive after 9News, based in Kusa, ran a piece that was critical of their billing practices.
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Providers Confront Growing Demand For Instant Access

April 18, 2017,   Modern Healthcare
Kim Dearnley couldn't call in sick after waking up recently with a sore throat.As a computer trainer, she had limited sick days.So she turned instead to the internet, where she found that the wait time was just 20 minutes at an Advocate Clinic at a Walgreens in her Chicago neighborhood.
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CMS Final Rule Gives Insurers Greater Options for Benefit Design on Obamacare Exchanges

April 13, 2017,   Healthcare Finance News
The Centers for Medicare and Medicaid Services has issued the final market stabilization rule for insurers in the Affordable Care Act market that includes a shortening the open enrollment period for 2018. Also, for the 2018 plan year and beyond, the final rule gives issuers greater benefit design in allowing additional actuarial value flexibility to develop more choices with lower premium options for consumers, CMS said.
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Value-Based Programs Yield Lower Readmission Rates, Significant Cost Savings, JAMA Study Shows

April 13, 2017,   Healthcare Finance News
As the healthcare industry continues it's slow but sure transition to value-based care, the positive effect this may have on hospitals is emerging, with those taking part in one or more value-based programs showing lower readmission rates and bigger cost savings, according to the Journal of the American Medical Association.
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Leapfrog Releases Hospital Safety Grades, Says 1,000 Patients a Day Still Killed by Medical Errors

April 12, 2017,   Healthcare Finance News
The Leapfrog Group on Wednesday released its Spring 2017 Hospital Safety Grade, highlighting hundreds of hospitals that are leading in preventing deadly medical errors at their facilities. The Leapfrog Hospital Safety Grade, the first and only national healthcare rating focused on errors, accidents and infections, assigns A through F letter grades to general acute-care hospitals.
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Uninsured Rate Swells to 11.3% in First Quarter 2017 After Record Low

April 11, 2017,   Healthcare Finance News
The number of Americans without health insurance swelled to 11.3 percent during the first quarter 2017, compared to 10.9 percent in the third and fourth quarters of 2016, according to a Gallup-Healthways poll. The 11.3 percent represents a record low since Gallup and population health company Healthways began tracking insurance coverage in 2008.
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CMS Readies Insurance Market Stabilization Rule as Insurers Wait Nervously

April 3, 2017,   Modern Healthcare
The CMS has sent a rule designed to stabilize the individual health insurance market to the Office of Management and Budget for final review. The Trump administration hopes to finalize the rule very soon.
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As Payers See Success in Bundled Payments, Critics Say Model Needs Fine-Tuning

March 13, 2017,   Healthcare Finance News
Commercial plans are following Medicare's lead, but physicians need more flexibility, experts say.
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10 States With the Highest Rates of Past-Due Medical Debt in 2015

March 1, 2017,   Becker's Hospital CFO
Almost one in four non-elderly Americans had medical debt past-due in 2015, and it was more common in states with high rates of uninsured people, according to a recent study conducted by the Urban Institute.
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Hundreds of Rural Hospitals Already at Risk of Closing as ACA Repeal Looms, Increasing Their Vulnerability

February 27, 2017,   Healthcare Finance News
Even if the Affordable Care Act were to remain intact, upwards of 670 rural hospitals across the country are at risk of shutting their doors, according to findings from iVantage Health Analytics. But with the federal health law threatened by Republican majorities in Congress, thin margins will likely turn into losses.
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Healthgrades Names 100 Top Hospitals For 2017; See the List

February 24, 2017,   Healthcare Finance News
Healthgrades has released its list of America's 50 and 100 Best Hospitals for 2017 for demonstrating what the organization calls "superior clinical outcomes" across the majority of common inpatient conditions and procedures for at least three consecutive years.
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Vital Signs: Does the U.S. Have the Right Mindset For Value-Based Care?

February 24, 2017,   Modern Healthcare
Is the U.S. healthcare industry thinking about value-based care the right way? No, or at least, not yet, suggested a panel of executives at Columbia Business School's annual healthcare conference in New York City Friday.
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Healthcare Costs Will Outpace Medicare Advantage Payments in 2018, Report Says

February 23, 2017,   Healthcare Finance News
Proposed rate changes to Medicare Advantage rates in 2018 would result in an estimated 2 percent reduction in MA insurer net revenues, which could mean cuts to beneficiary coverage and benefits, according to a Feb. 22 report by Oliver Wyman, sponsored by America's Health Insurance plans.
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CMS: Health Spending Growth Will Outpace Projected Growth in GDP

February 16, 2017,   Healthcare Finance News
New estimates released Wednesday from the Office of the Actuary at the Centers for Medicare and Medicaid Services project an average rate of national health spending growth of 5.6 percent for 2016 to 2025, outpacing the average projected growth in gross domestic product by 1.2 percent.
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AHA Survey Shows Variation in Hospital Expenses

February 16, 2017,   Modern Healthcare
New survey data from the American Hospital Association underscore the wide variation in hospital expenses from state to state and between different types of facilities. Adjusted expenses per inpatient day in 2015 were highest at not-for-profit hospitals, at $2,413, and lowest at for-profit hospitals, at $1,831, according the AHA's latest annual survey.
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Revenue Cycle Departments Must Be More Patient-Centered to Succeed, Experts Say

February 9, 2017,   Healthcare Finance News
When it comes to the biggest challenges facing revenue cycle professionals, the new role patients have in paying for the cost of care is one of the most pressing.
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Trump's ACA Executive Order Heightens Insurance Market Jitters

January 22, 2017,   Modern Healthcare
President Donald Trump's executive order Friday evening instructing federal agencies to go as far as they legally can to roll back the Affordable Care Act was not exactly surprising. But the order - along with Trump senior advisor Kellyanne Conway's statement Sunday that Trump may stop enforcing the law's tax penalty against people who don't buy insurance - has rattled insurers and health policy experts.
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Data Points: Healthcare Data Breaches

January 21, 2017,   Modern Healthcare
Late last year, Quest Diagnostics disclosed that hackers infiltrated its patient portal, gaining access to names, dates of birth, telephone numbers and lab results. The frequency and scope of data breaches - from cyberattacks to simple theft and loss - has grown along with the exploding volume of digitalized information in healthcare delivery and financial transactions.
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CMS Announces 45 ACOs Are Now Participating in Next Generation Model

January 20, 2017,   Healthcare Finance News
The Centers for Medicare and Medicaid Services has announced 45 providers that are participating in the Next Generation accountable care organization model, up from an estimated 17 the year before.
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Upward Trend in Merger, Acquisition Activity Continues With Nonprofits Leading the Charge

January 20, 2017,   Healthcare Finance News
Hospital and health system partnership and merger transaction continue an overall uptick, jumping 55 percent from 66 announced in 2010 to 102 in 2016, management and consulting firm Kaufman Hall said in an analysis released earlier this week.
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CMS: More Than 359,000 Clinicians to Participate in Top APMs in 2017

January 18, 2017,   Healthcare Finance News
A mere two days before leaving Washington, officials at the Centers for Medicare and Medicaid Services touted gains in alternative payment models that have resulted in more than 359,000 clinicians confirmed to participate in four of the agency's top APMs in 2017. CMS called it 'an important part of the Administration's effort to build a system that delivers better care and one in which clinicians work together to have a full understanding of patients' needs.
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CMS Extends Hospital eCQM Reporting Deadline

January 18, 2017,   Healthcare Finance News
The Centers for Medicare and Medicaid Services has extended the deadline for hospitals to submit electronic clinical quality measure data for the 2016 reporting period. The eCQM reporting is to determine payment for 2018.
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House Advances ACA Repeal In Budget Resolution

January 13, 2017,   Healthcare Finance News
House members voted 227 to 198 on Friday to advance repeal of the Affordable Care Act in a budget resolution bill. The budget will allow Republicans to pass any repeal and replacement of ACA with a simple majority vote in a procedural tool known as reconciliation.
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Study Finds CMS' Hospital Readmission Penalties Worked Under Affordable Care Act

December 27, 2016,   Modern Healthcare
In 2012, Medicare began using a new tactic to get hospitals to reduce costly, unnecessary readmissions: It fined them. The Hospital Readmissions Reduction Program, established in the 2010 Affordable Care Act, allows the CMS to withhold inpatient prospective payments to short-term acute hospitals with excessive readmissions for certain conditions.
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Judge Drops Blue Shield of California Class-Action Suit Over Hep C Drug Denials

December 27, 2016,   Modern Healthcare
A federal judge dismissed a class action against Blue Shield Life & Health and Blue Shield of California alleging the insurers unfairly denied patients coverage for the expensive hepatitis C drug Harvoni.
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52 Million People With Pre-Existing Conditions Could Be Denied Coverage If Obamacare Provision Is Dropped

December 13, 2016,   Healthcare Finance News
More than 1 in 4 adults younger than 65 live with conditions that private insurers could have declined to cover in some policies prior to the Affordable Care Act, according to an analysis by the Kaiser Family Foundation.
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Hospital CFOs Should Be More Nimble, Leverage Technology, Says Kaufman Hall

December 8, 2016,   Healthcare Finance News
As the role of the hospital chief financial officer changes to adapt to reimbursement changes in healthcare, a new survey found 91 percent of global CFOs and senior finance professionals think their organization should be doing more with data to inform their strategic decisions.
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House Passes Healthcare Bill With HOPD Provisions

November 30, 2016,   HFMA
The U.S. House of Representatives passed omnibus healthcare legislation Wednesday that would preserve payment rates for more off-campus hospital outpatient departments, among other provisions sought by hospitals.
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HIMSS Says Federal Government Needs a National Chief Information Security Officer

November 15, 2016,  Modern Healthcare
A national chief information security officer could help stem the flood of data breaches hitting the healthcare industry, according to the country's largest healthcare IT industry trade association.
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HHS Taps Reserves to Ease Projected Part B Premium Rise

November 11, 2016,  Fierce Healthcare
One-third of Medicare beneficiaries will see a 10 percent Part B premium increase next year - less than originally projected because of intervention from federal health officials.
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Site-Neutral Pay Rule Leaves Hospital-Owned Outpatient Facilities With Uncertain Future

November 2, 2016,  Modern Healthcare
Although the CMS relaxed some controversial provisions in its final rule on how off-campus facilities will be reimbursed by Medicare, experts say the change will still put pressure on hospitals' relationships with commercial payers and prevent them from bringing care closer to patients.
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Double-Digit Premium Hikes Unlikely to Affect Most ACA Shoppers

October 25, 2016,  Modern Healthcare
Health insurance premiums for the benchmark exchange plans are set to rise 25% on average in 2017. But policy experts say the projected double-digit hikes are unlikely to affect the majority of people who enroll in health plans through the federal exchange.
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Errors Plague Medicare Advantage Provider Directories

October 25, 2016,  Fierce Healthcare
A new Centers for Medicare & Medicaid Services review revealed at a recent industry conference found that almost 46 percent of the 5,832 doctors listed in 54 private MA plans provided wrong information, limiting beneficiaries’ ability to get needed care.
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Healthgrades 2017 Report Ranks Top Hospitals

October 18, 2016,  Healthcare Finance News
Healthgrades published its ratings of hospitals across the country, and also launched its Risk IQ Tool to help consumers assess their personal risk to six common surgical procedures. See the top 50 hospitals that Healthgrades ranked based solely on clinical outcomes.
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CMS Releases MACRA Final Rule, Makes 2017 'Transition Year,' Adds 90-Day Reporting Option

October 14, 2016,  Healthcare Finance News
The Centers for Medicare and Medicaid Services on Friday released the final version of its physician Quality Payment Program under MACRA that it said adds flexibility like 90-day reporting to the program to overhaul how physicians are paid under Medicare.
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Value-Based Pay, Wellness, Retail Clinics Among 5 Top Forces Reshaping Healthcare, PricewaterhouseCoopers Says

September 22, 2016,  Healthcare Finance News
The shift from volume to value; wellness and health management; system decentralization; technological advances and digitization; and consumerism are the five biggest forces driving change in the U.S. healthcare industry, according to new findings from PricewaterhouseCooper's Health Research Institute.
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More Americans Gain Health Coverage, But Their Cost-Sharing Keeps Rising

September 17, 2016,  Modern Healthcare
The U.S. uninsured rate fell to another historic low in 2015, and premiums for employer-based plans barely budged in 2016. But those positive insurance numbers mask the fact that more Americans are becoming “underinsured” and face higher out-of-pocket obligations.
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Mid-Cycle Losses Have Healthcare Focusing on Coding, Predictive Analytics to Improve Revenue Cycle

September 6, 2016,  Healthcare Finance News
More hospital and health systems are turning their attention to their revenue cycle's mid-cycle operations as cost pressures force providers to shore up areas where systems are losing money.
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Hospitals May Not Get Clear Answers From Early CJR Data

August 22, 2016,  Healthcare Financial Management Association
Newly released Medicare data may not provide much help to the 800 hospitals subject to the first mandatory payment bundle, industry watchers say. But that doesn’t mean those hospitals should be sitting still.
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Get Ready For the End of ICD-10 'Flexibilities'

August 19, 2016,  Modern Healthcare
The CMS has issued an 11-page list of questions and answers to better guide providers in using ICD-10 codes. The federally mandated conversion to the more numerous and granular ICD-10 family of diagnostic and procedural codes began Oct. 1, 2015, but not before the American Medical Association and other groups extracted concessions from the CMS.
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Locky Ransomware Attacks Hit Hospitals the Hardest, Report says

August 19, 2016,  Healthcare Finance News
Locky ransomware is back in the spotlight, after FireEye Labs, a cybersecurity and malware protection provider, observed the virus has evolved and is targeting hospitals with a massive campaign.
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See Which Hospitals Will Pay Readmission Fines in 2017

August 4, 2016,  Healthcare Finance News
More than half of U.S. hospitals will be penalized in fiscal 2017 for having readmission rates higher than the acceptable level set by the Centers for Medicare and Medicaid Services. And for many of them, the latest payment reduction marks the 5th year in a row that CMS has adjusted the rates based on their readmissions.
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Bundled-Payment Expansion Brings Providers More Risk—and Opportunity

July 30, 2016,  Modern Healthcare
The CMS announced a proposal last week to put three new episodes of care under mandatory experiments with bundled payments, potentially compelling hundreds of additional hospitals into becoming financially accountable for what happens to Medicare patients long after they leave the hospital.
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43 States Flunk When it Comes to Healthcare Price Transparency, Groups Say

July 27, 2016,  Healthcare Finance News
The majority of states could be doing more to make price transparency the norm and enable educated healthcare choices for consumers, according to a joint report from the Health Care Incentives Improvement Institute and Catalyst for Payment Reform, two independent health policy groups.
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California Will Get Nearly $2 Billion in Uncompensated-Care Funds

July 19, 2016,  Modern Healthcare
California's public hospitals will receive up to $472 million annually for the remaining four years of a waiver meant to reform the state's Medicaid program.
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Insurers Suffer Large Losses in Individual Market, George Mason University Report Finds

June 20, 2016,  Healthcare Finance News
Despite receiving huge subsidies, insurers suffered larger losses selling qualified health plans in the individual market than they did selling nearly identical policies in the small group market, a new study from George Mason University has found.
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Affordable Care Act Policy Changes Could Severely Impact Hospital Financial Viability

June 15, 2016,  Healthcare Finance News
ACA calls for reductions in DSH payments, and other federal policy changes are focused on limiting the use of supplemental payments, analysis shows.
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American College of Emergency Physicians Sues HHS Over Emergency Payment Rules

May 24, 2016,  Healthcare Finance News
The American College of Emergency Physicians is suing the Department of Health and Human Services and other federal agencies for setting payment rules that result in inadequate reimbursement for out-of-network emergency medical services, according to the civil lawsuit filed in U.S. District Court on May 12.
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Legislation Would Allow for Higher Outpatient, Off-Campus Payment Rates

May 20, 2016,  Healthcare Finance News
Bipartisan legislation introduced Wednesday by the leaders of the House Ways and Means Subcommittee on Health resolves two provisions of the Bipartisan Budget Act of 2015 in allowing hospitals that are building outpatient facilities off-campus to be paid at higher reimbursement rates, and in taking into consideration for payment, socioeconomic status.
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Analyze This: Health Systems, Health Plans Get to the Core of Big Data

May 11, 2016,  Healthcare Finance News
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.
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Florida Bill on Healthcare Transparency Headed to Governor

March 12, 2016,  Modern Healthcare
A bill that would give Florida residents greater transparency on healthcare costs is headed to Gov. Rick Scott. The Florida Senate passed the bill (HB 1175) by a 34-1 vote Friday, which was the final day of the legislative session.
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Bad Debt Is the Pain Hospitals Can't Heal as Patients Don't Pay

February 23, 2016,  Bloomberg
A type of pain that hospitals thought they had relieved has come back with a vengeance: it’s called bad debt. Hospitals have long struggled to collect bills when patients aren’t covered by insurance -- creating delinquent accounts. The Affordable Care Act was supposed to relieve some of that strain by helping pay for coverage for millions of Americans and expanding Medicaid in some states to cover the poor.
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Insurance Deals Win Over States, but Feds Still in Doubt

February 16, 2016,  CNBC
The four major health insurers currently pushing for mergers — Aetna and Humana, and Anthem and Cigna — are still a long way from gaining federal approval. But they say they're optimistic their respective deals will close by year-end, in part because they have had success getting the nod from state regulators.
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Nearly 13 Million Sign Up for Obamacare Health Insurance

February 4, 2016,  NBC News
About 12.7 million Americans signed up for 2016 health insurance coverage through the government insurance exchanges, surpassing its expectations, U.S. Health and Human Services Secretary Sylvia Burwell said on Thursday.
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Healthcare Providers Must Weigh High Value vs. High Prices

December 14, 2015,  Healthcare Finance News
It's not about cost, but value, according to a panel of revenue cycle professionals who work in health systems that often charge more for care than other providers.
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More Risk Shifting to Hospitals, Pressuring Revenue Cycle, Experts Say

December 8, 2015,  Healthcare Finance News
The boundary between being a provider and a payer is blurring as hospitals face more risk, according to Joe Nichols of Health Data Consulting, prompting health systems to make changes to keep from losing too much money.
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20 States with the Largest Drop in Uninsured Rates

September 17, 2015,  Becker's Hospital Review
New health insurance data from the U.S. Census Bureau shows the uninsured rate has dropped in all 50 states and the District of Columbia. The numbers, which include data from calendar year 2013 and calendar year 2014, show the states that chose to expand Medicaid and/or run their own health insurance marketplace saw the greatest decrease in the number of uninsured.
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The Culture of Patient Experience

July 25, 2015,  Healthcare Finance News
For providers to thrive under healthcare payment and delivery model reform, the patient experience must align with the patient expectation.
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Crisafulli: Why the Florida House Opposes Medicaid Expansion

April 28, 2015,  Tampa Bay Times
In 2012, the U.S. Supreme Court gave states the option to expand Medicaid under Obamacare and Florida has chosen not to expand. There are principled reasons for declining to grow a program that currently covers 3.7 million Floridians at a cost of $23.5 billion per year, or about one-third of Florida's budget.
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CMS Chief Says Interoperability is the ‘Price to Play’

April 16, 2015  H&HN
In a word, it is all about interoperability. Appearing together for a keynote session at HIMSS15, ONC chief Karen DeSalvo, M.D., and CMS Acting Administrator Andy Slavitt made it clear that vendors, providers and the government need to pick up the pace on an issue that has vexed the industry for the past decade or more.
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CMS Takes Tougher Medicaid Stance to Texas

April 20, 2015,  Modern HealthCare
Texas officials and the Obama administration are nearing a showdown over Medicaid expansion that threatens billions of dollars of federal funding that helps healthcare providers care for low-income Texans and improve the quality of care.
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Oscar, a Health Insurance Start-Up, Valued at $1.5 Billion

April 20, 2015,  NY Times
Sixteen months after going live, the insurance company Oscar has joined the elite group of start-ups known as unicorns, or those with billion-dollar valuations.
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In U.S., Uninsured Rate Dips to 11.9% in First Quarter

Gallup
The uninsured rate among U.S. adults declined to 11.9% for the first quarter of 2015 -- down one percentage point from the previous quarter and 5.2 points since the end of 2013, just before the Affordable Care Act went into effect. The uninsured rate is the lowest since Gallup and Healthways began tracking it in 2008.
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Worker Out-Of-Pocket Health Costs Have Doubled In Five Years

October 13, 2014   Forbes
As the economy improves and employees spend more on health care, employer-paid premiums are rising again with an increase of 5.5 percent forecast for 2015 with worker premiums and out-of-pocket costs – which have doubled since 2009 – rising at an even faster clip.
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Medicaid and CHIP Enrollment Grows by 8.7 Million Additional Americans

October 17, 2014  HHS.gov
Today’s report shows that while enrollment in states that expanded Medicaid has risen by 22 percent since before open enrollment in the Marketplace began, states that have not expanded reported only a 5 percent increase in enrollment during this same period.
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Email 10 Leadership Lessons From "The Front-Line Leader"

October 27, 2014  Forbes
Chris Van Gorder, CEO of Scripps Health, has been a remarkable leader for the San Diego-based, five-hospital system. After joining the system in 2000, at a time when the medical staff had voted no confidence in the previous administration and the system was losing millions, Chris led its remarkable $150 million turnaround. And he did so without any layoffs. Today, Scripps' facilities routinely appear in national hospital rankings, and the system recently opened a $220 million cancer center and has a $450 million cardiac center in the works.
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Is the Affordable Care Act Working?

October 26, 2014,  NY Times
After a year fully in place, the Affordable Care Act has largely succeeded in delivering on President Obama’s main promises, an analysis by a team of reporters and data researchers shows. But it has also fallen short in some ways and given rise to a powerful conservative backlash.
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Like It Or Not, Obamacare Is Reshaping The Healthcare Industry

October 7th 2014, Forbes
As we approach the one-year anniversary of Obamacare’s launch, the pundits continue to argue over whether or not it’s working. Meanwhile, something much bigger is happening. Whatever you think of its merits, the Affordable Care Act is re-shaping American healthcare, radically altering business models that hadn’t changed in decades.
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Why Hospitals Want Patients to Pay Upfront

September 25, 2014,  Bloomberg Businessweek
Melody Rempe spends much of her day telling people who are about to go into the hospital how much they’ll have to pay. As a patient financial counselor at Nebraska Methodist Health System, she calls patients about a week before they go in for procedures with estimates of their bills and what portion insurance will cover.
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Hospitals' Uncompensated Care Will Drop $5.7 Billion This Year: HHS

September 24, 2014, Modern Healthcare
The Obama administration has a new projection (PDF) of the benefit hospitals will enjoy this year as they provide less care that no one pays for: $5.7 billion. Hospitals in states that expanded Medicaid are getting most of it.
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How Technology Is Going To Disrupt Health Care

September 22, 2014, Forbes
In 1000 BC, the only early test for diabetes was whether your urine attracted ants. In 2012, 25.8 million United States residents with diabetes spent USD 245 billion on diabetes, a figure presently rising by 7% per annum.
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CMS Conducting End-to-End ICD-10 Testing; Apply by Oct. 3

September 22, 2014, AMA Wire
In advance of ICD-10 implementation scheduled for Oct. 1 of next year, the Centers for Medicare & Medicaid Services (CMS) plans to conduct end-to-end testing in January to identify issues in the system that need to be addressed. Physicians who are interested in participating should apply by Oct. 3.
Read more.

Leverage Revenue Cycle Systems To Stop Hemorrhaging Money

August 20, 2014, Health IT Outcomes
If there's any application of IT in healthcare that can resonate with CFOs, it's revenue cycle. On average, hospitals in the U.S. write off between 3 and 17 percent of their revenue due to payer denials.
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The Beginner's Guide to New Health Care Payment Models

July 23, 2014, Brookings
Payment reform in health care is confusing, but the goal is simple: How can health care providers change their economic incentives to encourage value over volume? If you've wondered about how these new payment models work, we're here to help.
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Hospitals Push Bundled Care as the Billing Plan of the Future

June 8, 2014, The Wall Street Journal
Hospital bills may soon get a lot simpler. Traditionally, hospitals have charged patients separately for every service and supply they use—as anybody who has waded through pages of charges knows. Fees for surgeons, anesthesiologists and other providers come in complex bills of their own.
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CMS' 2015 IPPS Proposed Rule: 10 Points to Know

May 1, 2014, Becker's Hospital Review
Many hospitals face further decreased Medicare reimbursements next year, as CMS released its proposed rule for the fiscal year 2015 Medicare inpatient prospective payment system.
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