House Republicans recently proposed the American Health Care Act, a new piece of legislation aimed at replacing the Affordable Care Act. While this legislation may change as it makes its way through Congress, the following proposed ideas are likely to appear – at least in some form – in the final bill: 1. Medicaid expansion [...]
Rising healthcare costs have prompted consumers to increasingly choose high-deductible insurance plans. As a result, much of the healthcare industry is now driven by out-of-pocket costs rather than government or commercial payers. Therefore, healthcare providers must now focus on working directly with patients to settle their account balances. Watch as Kathleen Zuniga discusses [...]
The new revenue recognition standard could drastically changes how healthcare entities (particularly hospitals) recognize revenue – specifically, when and how much to recognize. Watch as Bryan Hall provides an overview of these changes, as well as the data that hospitals should begin collecting now to implement the new mandate.
The Five-Star Quality Rating System is designed to help consumers choose the best long-term care facility for their loved ones. As the tool undergoes significant changes, nursing homes must stay up-to-date so that they understand how they will bne evaluated going forward. Watch as Matt Taylor discusses some of these changes – such [...]
The Centers for Medicare & Medicaid Services (CMS) recently published their 2,434-page fiscal year 2017 Hospital Inpatient Prospective Payment System (IPPS) Final Rule. The hospital community eagerly anticipated this new arrival, especially its expected changes to Medicare disproportionate share hospital (DSH) payments. To illustrate the potential impact of the 2017 IPPS rule, we’ve highlighted three [...]
In January 2015, the Centers for Medicare & Medicaid Services (CMS) “cooked up” an initiative to quickly move the Medicare payment system away from traditional fee-for-service reimbursements and toward those linked to value and quality – including alternative (or value-based) payment models. Most, if not all, healthcare providers are at least partially affected by these [...]
Nursing Home ACA PBJ Reporting is Getting Messier, But Here’s a Recipe for Success While peanut butter and jelly sandwiches are not mentioned in the Patient Protection and Affordable Care Act (ACA), almost everyone knows that individual and employer sponsored health insurance mandates are. However, many people often do not realize that many other health [...]
Healthcare cost reports not only satisfy regulatory requirements, but they can also yield beneficial information to help healthcare providers increase transparency with patients. Watch Bart McCurley as he discusses three ways in which healthcare cost reports can provide greater organizational value.
With the increased focus on quality in the healthcare industry, organizations that prioritize quality patient care can reap important financial benefits. Watch as Rodney Thornton discusses how quality can help physician practices increase revenue.
Physician compensation models are more art than science. While two basic models dominate within the industry, it's very common for medical practices to tailor compensation plans to meet their specific needs. Dale Cooper discusses trends in physician compensation models and the popularity of a hybrid compensation model.
The Centers for Medicare & Medicaid Services (CMS) established the recovery audit program (commonly known as RAC audits) to identify and correct improper Medicare payments. Unfortunately, third-party auditors are compensated on the amount of funds they recover, which leads to interpretations that often aren't favorable to healthcare entities. Watch Doug Berry discuss what [...]
Downward pressure on reimbursements continues to affect the bottom line revenue in the healthcare industry. As a result, healthcare entities are tasked with cutting expenses to maintain profit margins. Watch Bryan Hall discuss healthcare challenges - and why staffing, vendor benchmarking, and contract management are more important to healthcare entities than ever before. [...]
Medical practices seek effective ways to prepare for the arrival of new patients receiving health care coverage through the Affordable Care Act’s (ACA’s) new Health Insurance Marketplaces and expanded Medicaid programs. Non-physician providers (NPPs), including nurse practitioners, nurse midwives, physician assistants, and physical therapists can provide much-needed support in this new healthcare era. However, for [...]
Medical practices face many dilemmas in today’s healthcare landscape–from decreased reimbursements to increased patient demands—while fighting extinction in the current competitive environment. Overlooking certain operational efficiencies can lead to revenue loss, but not keeping those binoculars focused on changes to Medicare regulations can also lead to compliance issues–and even fraud. Observe Common Medicare Fraud Red [...]
Community Health Systems (CHS), the largest for-profit hospital company in the U.S., recently announced a massive patient data breach due to an unprecedented malicious software (a.k.a. malware) attack. Per CHS’s disclosures, the company experienced sophisticated malware attacks April and June of 2014 from a group that may have originated in China. The group obtained names, [...]