Tag: Revenue Cycle Management

How Policy, Regulation Will Challenge Consolidation in Healthcare

How Policy, Regulation Will Challenge Consolidation in Healthcare

  A new executive order is putting consolidation in healthcare in the spotlight; industry experts share what policy and regulation will mean for provider merger and acquisition activity. Healthcare mergers and acquisitions have promised to bring lower costs, higher quality, and better access to care. But a new executive order is challenging the rapid pace […]
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Hospital Pros and Cons of the CY 2022 OPPS Proposed Rule

Hospital Pros and Cons of the CY 2022 OPPS Proposed Rule

Hospital groups are digesting the 863-page CY 2022 OPPS proposed rule, but many are already commenting on new hospital price transparency penalties and other policies. The newly proposed Medicare Outpatient Prospective Payment System (OPPS) rule for calendar year (CY) 2022 is causing a stir with new hospital price transparency enforcement rules and other policies. The […]
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Payer Moves to Increase Member Access to Acute Home Healthcare

Payer Moves to Increase Member Access to Acute Home Healthcare

Regence BlueShield’s new partnership will offer members access to quality acute home healthcare services. Regence BlueShield (Regence) has partnered with a home healthcare provider to increase member access to acute home healthcare services. Regence members in Pierce County, Washington will have access to the new program. The payer plans to expand the acute home healthcare […]
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Telemedicine Use Higher Among PCPs with Value-Based Payment

Telemedicine Use Higher Among PCPs with Value-Based Payment

A study of Medicare Advantage enrollees during the COVID-19 pandemic found that telemedicine use soared among primary care practices with value-based payment models. Telemedicine use skyrocketed among primary care practices during the pandemic, specifically for those with a value-based payment model, according to a research letter published in JAMA Health Forum. Many patients were forced […]
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CMS Forecasts Increase in Dialysis Payment, Health Equity Gap Reduction

CMS Forecasts Increase in Dialysis Payment, Health Equity Gap Reduction

Proposed rule improves payment rates, incentives, and ESRD treatment choices. Disadvantaged Medicare patients suffer from end-stage renal disease (ESRD) at higher rates and are also more likely to be readmitted to hospitals, experience higher costs, and receive in-center hemodialysis when their kidneys are no longer able to function properly. Furthermore, non-white patients with ESRD are […]
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Despite Drop in Healthcare Mergers and Acquisitions, Revenue Rises

Despite Drop in Healthcare Mergers and Acquisitions, Revenue Rises

Analysis from Kaufman Hall reveals a historically low number of healthcare mergers and acquisitions in Q2, but revenue continues to rise. Healthcare merger and acquisition (M&A) activity was minimal in Q2, but total transacted revenue rose as health systems focused on acquiring smaller hospitals and strengthening regional partnerships, according to Kaufman Hall’s quarterly M&A report. […]
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4 Reasons Why UnitedHealthcare’s Attempt To ‘Monday Morning Quarterback ED Claims Is ‘Bad Policy’

4 Reasons Why UnitedHealthcare’s Attempt To ‘Monday Morning Quarterback ED Claims Is ‘Bad Policy’

“It really undermines what the physicians are doing at the point of care, and it’s bad policy,” says Doug Wolfe, co-founder and partner of the Miami-based law firm Wolfe Pincavage. UnitedHealthcare’s attempt to “Monday morning quarterback” emergency room visits by retroactively denying emergency claims is not only likely a violation of the prudent layperson standard, […]
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