Read more about the article Is It Time for a Billing Operations Check-Up? How to Assess the Health of Your Revenue Cycle

Is It Time for a Billing Operations Check-Up? How to Assess the Health of Your Revenue Cycle

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Balancing the competitive landscape that comes with physician practice consolidation combined with population health and the shift to value-based care is a lot to consider for busy hospital physician practices. Add in the constant changes in regulatory guidelines, enhancing the patient experience and most importantly – a continued focus on quality and safety and most hospital administrators have little resources left to focus on improving the revenue cycle.

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Read more about the article 3 Ways Hospitals Can Improve Their CMS Star Rating (Regardless of its Flaws)

3 Ways Hospitals Can Improve Their CMS Star Rating (Regardless of its Flaws)

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Lots of questions and headlines began swirling earlier this month after the Centers for Medicare and Medicaid Services (CMS) released its hospital star ratings – a “seemingly” simple system designed to help consumers make informed decisions about hospitals and the care they deliver. While consumers are used to 5-star ratings for hotels and restaurants, the healthcare industry is clearly far more complex. As such, a cloud of mystery and skepticism surrounds this incredibly powerful rating system – especially for the thousands of hospitals who participate in Medicare and are therefore automatically subject to stardom whether they like it or not.

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Read more about the article 800 Hospitals Forfeit 1% of Revenue to CMS For Poor Performance

800 Hospitals Forfeit 1% of Revenue to CMS For Poor Performance

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Last week, CMS reported that 800 hospitals will be required to forfeit 1 percent of their reimbursement for missing the mark on reducing hospital-acquired conditions (HACs). The race to eliminate preventable patient harm has always been a top hospital goal, but now it’s one tied to their reimbursement through the Centers for Medicare & Medicaid Services Hospital-Acquired Condition Reduction Program (HACRP). No matter how hard hospitals work to improve their performance, CMS will penalize the lowest performing quartile (25%) of hospitals annually.

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Read more about the article CMS Will Only Adjust Medicaid Rules – Not Drastically Change Them

CMS Will Only Adjust Medicaid Rules – Not Drastically Change Them

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After much ballyhoo and for years of promising a major overhaul to the cost-prohibitive Obama-era managed care rules, the CMS has issued a proposed regulation that makes smaller changes – not the drastic “gutting” that had been promised — to the standards states meet when running their Medicaid plans.

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Read more about the article Billions of Dollars Flow into Private Medicaid Plans with NO Cost Oversight or Efficacy of Treatment Determined

Billions of Dollars Flow into Private Medicaid Plans with NO Cost Oversight or Efficacy of Treatment Determined

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Cost containment has become a leading factor in the delivery of healthcare. What are some of the issues that are contributing to these burgeoning costs? One of them is Medicaid. We spent over $576 billion on Medicaid programs in 2017, as reported by the Kaiser Family Foundation.

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