Tag: RCM Company

Low Reimbursement Rates Lead to Rural Hospital Closures

Low Reimbursement Rates Lead to Rural Hospital Closures

Low reimbursement rates, staffing shortages, low patient volumes, and regulatory barriers are some of the root causes of rural hospital closures, the American Hospital Association (AHA) explains in a new report. The report “Rural Hospital Closures Threaten Access: Solutions to Preserve Care in Local Communities” highlights the variety of causes behind rural hospital closures, which […]
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2023 Medicare Physician Fee Schedule on Unsustainable Cuts

2023 Medicare Physician Fee Schedule on Unsustainable Cuts

Lower Medicare payments to physicians will lead to patient care by reducing access to services, according to medical groups commenting on the 2023 Medicare Physician Fee Schedule (PFS). In July, the U.S. Centers for Medicare & Medicaid Services (CMS) announced the 2023 proposed rule and physician groups have been responding, including with detailed comments published […]
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Physician Practice Costs Grew 20% Per Claim

Physician Practice Costs Grew 20% Per Claim

Following a private equity acquisition, physician practices saw a 20.2 percent increase in charges per claim, an 11 percent raise in the allowed amount per claim, and a 37.9 percent increase in new patient visits. Private equity acquisition of physician practices in dermatology, gastroenterology, and ophthalmology was associated with increased healthcare spending and utilization, according […]
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More Versions to Come: No Surprises Act

More Versions to Come: No Surprises Act

Although the Biden Administration claims this is the final regulation, there is evidence more is yet to come. The Biden administration released the final No Surprises Act regulation recently but advised healthcare professionals that this final version is not the final one and promised more to come. The latest final rule was narrowly focused on […]
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Prior Authorization Reform in Medicare Advantage

Prior Authorization Reform in Medicare Advantage

Prior Authorization reform in Medicare Advantage would help relieve administrative burden for medical groups and reduce patient care delays, MGMA said. The Medical Group Management Association (MGMA) has urged CMS to implement policies that support prior authorization reform and value-based care contracts within the Medicare Advantage program. MGMA submitted comments to CMS Administrator in response […]
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Value-Based Payment makes up 6.7% of Primary Care Revenue

Value-Based Payment makes up 6.7% of Primary Care Revenue

Value-based payment is severely lacking as a percentage of total medical revenue across practices as providers face scheduling and billing challenges. The transition to value-based payment is moving at a snail’s pace despite healthcare’s long journey with the transition away from fee-for-service, new survey data indicates. Value-based payment made up just 6.74 percent of total […]
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Healthcare Revenue Goals Falling Short for Many Providers in 2022

Healthcare Revenue Goals Falling Short for Many Providers in 2022

Nearly half of CFOs and revenue cycle VPs in a recent survey said their organizations are behind their 2022 healthcare revenue goals. Most provider organizations are behind their 2022 healthcare revenue goals, according to a recent survey of health system and physician group finance leaders. Revenue cycle management technology vendor R1 RCM commission Census wide, […]
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CMS Proposes Changes to Medicare Advantage and Part D Programs

CMS Proposes Changes to Medicare Advantage and Part D Programs

On January 12, the Centers for Medicare & Medicaid Services (CMS) released the Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs proposed rule, representing CMS’ first major policy proposals for these programs in the Biden Administration. The changes proposed are, overall, modest in scope. In the […]
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Revenue cycle management 2.0: The key to successful healthcare finance

Revenue cycle management 2.0: The key to successful healthcare finance

This has, in turn, put greater emphasis on the need for Revenue Cycle Management (RCM) systems to enable a healthcare provider to better manage transactions between payer, provider and patients. It can, through the use of various software platforms, boost revenues, reduce denials and enhance the patient experience. According to a survey published by health […]
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