The federal government’s next action to improve price transparency among providers may be requiring organizations to publicize the contracted prices they charge insurance companies for services. A request for comment on this idea and other price transparency initiatives was slipped into a proposal to prevent health information blocking released in February by the Office of […]
Author: Courtney Zott
How the Revenue Cycle Will Need to Adapt to Value-Based Reimbursement
Value-based payment models are undoubtedly the future of health care. The number of commercial and governmental ACO contracts alone increased by an average of 63% annually from Q1 2011 to Q1 2018, according to a Muhlestein et al. analysis of Leavitt Partners’ data. Though commercial payers have been slower to adopt other models that are […]
What Providers Should Know About the ACA Ruling
A federal judge’s ruling against the Affordable Care Act last week has providers facing the unnerving prospect of a future without the landmark law to which they have spent years adapting. On Friday, Judge Reed O’Connor of the Federal District Court in Fort Worth struck down the ACA in a lawsuit brought in part by […]
Proposed Immigration Rule Could Increase Uncompensated Care
Health systems may need to prepare for an increase in uninsured immigrant patients—and thus uncompensated care—if a new proposal from the Department of Homeland Security is finalized. The agency issued a proposal on October 10 to have the types of public benefit usages the U.S. is allowed to consider in denying immigrants lawful permanent residence […]
Three Lessons You’ll Learn During HBI’s Price Transparency Roundtable
Hospital prices have been coming under increased scrutiny amid rising patient consumerism and regulatory attention. Most recently, CMS issued a new regulation requiring providers to publicize standard charges online on January 1, 2019. In this climate of transparency, organizations’ strategies for informing patients of their care costs are more important than ever. Leaders from University […]
CMS’ 2019 Outpatient Prospective Payment System Proposal: What Providers Should Know
CMS on Wednesday released a proposal for the 2019 Outpatient Prospective Payment System and Ambulatory Surgical Centers Payment System that would expand controversial site-neutral payment policies and 340B drug cuts. Site-Neutral Payment Proposals The agency is proposing to reimburse clinic visits—which it describes as checkups—provided at off-campus facilities at the same rate as clinic visits […]
CMS’ 2019 Physician Fee Schedule Proposal: What Providers Should Know
CMS proposed multiple changes last week to physician coding, documentation, and reimbursement in its proposed Physician Fee Schedule and Qualified Payment Program updates for 2019. Under the new rules, the agency would: Reimburse for certain telehealth services. Specifically, providers would receive payment for brief virtual check-ins via phone or other telecommunication device and for time […]
Two Lessons You’ll Learn from Sutter Health During HBI’s June Webinar
It’s common knowledge that training is essential to eliminating common revenue cycle issues—but what if you could quantify just how essential? At Sutter Health, leaders are pioneering this capability with a combined training and analytics department that designs, delivers, and measures the impact of training programs. Patrick McDermott, senior vice president of revenue cycle, and […]
Considering the Impacts of the FASB’s New Revenue Recognition Standards
New accounting standards issued by the Financial Accounting Standards Board will significantly alter how organizations recognize bad debt, though what that will mean for the revenue cycle is still uncertain. The rules took effect after December 15, 2017, for public healthcare entities and are set to take effect after December 15, 2018, for all others. […]