A long-awaited and controversial final rule on healthcare price transparency was released Thursday by the federal government. The rule, mandated under a June 2019 executive order by President Donald Trump, requires private group health plans and individual health insurance market plans to disclose pricing and cost-sharing information in a consumer-friendly format. The mandate, which takes effect on January […]
A new interim final rule with comment period ensures Medicare reimbursement for the administration of a COVID-19 vaccine and provider use of innovative treatments for the novel coronavirus. The rule released last night states that Medicare will pay providers $28.39 for the administration of a single-dose COVID-19 vaccine. In the event an approved COVID-19 vaccine requires multiple […]
Practices have been creative during COVID-19 to ensure safe patient access: Telephone visits. Curbside immunizations. Drive-up virus testing. Even checking patients in for their in-office visits while they wait in the car. However, each of these scenarios poses one significant challenge: Collecting copayments and coinsurance. “With COVID-19, you’ve got to find ways to meaningfully engage […]
Clinicians who served more patients with social risk factors such as low income performed worse in the Merit-Based Incentive Payment System’s inaugural payment year, and therefore, received unfavorable value-based reimbursement, according to a new study. The study recently published in Health Affairs found that out of 510,020 clinicians participating in the Merit-Based Incentive Payment System (MIPS) in […]
As RPA’s value for revenue cycle continues to be explored, leaders need to go beyond the hype and determine a practical path to innovation that takes into account the organization’s capacity for innovation and the road map that will best take the organization to its desired digital destination. A recent survey shows 15% of healthcare revenue cycle […]
The COVID-19 pandemic has proven that fast, meaningful change is both possible and necessary for healthcare revenue cycles to keep up with a changing world. But to make truly meaningful change within the revenue cycle, the industry will need to embrace even more changes, such as payer partnerships, greater automation, and standardization across payers. Payer-provider […]
Telehealth use has surged during the coronavirus pandemic, with the technology spreading far and fast. Doctors and patients alike must be wondering if this is the beginning of a whole new kind of doctor–patient relationship, one that might totally transform our health care system? Maybe. But I’m not convinced, and Americans may not be either […]
During the Coronavirus pandemic, the Centers for Medicare and Medicaid Services (CMS) has taken unprecedented action to expand telehealth for Medicare beneficiaries. Since people were advised to stay at home to reduce risk of exposure of COVID-19, there was an urgency to increase access to telehealth services to help people who need routine care and […]
Every year, the Trends in Healthcare Payments Annual Report is distributed to start a conversation about the current state of the industry and shine a light on areas where change is needed. For healthcare providers, the report has consistently found that more of their revenue is dependent on out-of-pocket payments from consumers and less is covered […]
CMS is now offering MIPS credit for all participating clinicians of the Quality Payment Program to help report and provide COVID-19 data. The Centers for Medicare & Medicaid Services (CMS) is asking all clinicians in the Quality Payment Program (QPP) to contribute to the scientific research and reporting efforts to help curb the spread […]










