Reimbursement

By 2014, the core operating rules will likely have a major effect on reimbursement and revenue cycle processes and, as a result, payments, according to speakers who represented the payer, provider and banking perspectives at a Tuesday session titled "The Business Side of Care" during the 2013 HIMSS Annual Conference & Exhibition.

Doctor-owned hospitals are earning many of the largest bonuses from the federal health law's new quality programs, even as the law halts their growth.

Maryland Governor Martin O'Malley is expected to sign legislation expanding Medicaid eligibility and funding the state health insurance exchange with funds from an existing insurance tax.

U.S. healthcare prices dropped marginally in March 2013, falling 0.1 percent from February 2013 prices, according to the federal Bureau of Labor Statistics.

As the dust settles from the Supreme Court's ruling on the constitutionality of the Affordable Care Act (ACA), the results of the presidential election and, more recently, the sequester cuts, acute care providers are now turning attention to the looming reimbursement cuts.

President Barack Obama's fiscal 2014 budget includes a variety of what he says are "manageable" changes for Medicare's 54 million beneficiaries as well as for the hospitals, nursing homes and other healthcare providers that serve them.

In January, the Affordable Care Act (ACA)’s individual mandate will enter the next phase of its roll out. Millions of uninsured Americans will face penalties if they do not enroll in a health plan. Uninsured problem solved, right?

With no comprehensive program designed to provide long-term care insurance, a panel of experts who convened in March agreed that comprehensive reform has about a five-year window for implementation in order to sufficiently meet the needs of baby boomers.

Among the least popular decisions handed down by the Centers for Medicare & Medicaid Services in recent years, it’s hard to top the rule requiring hospitals to rein in readmission rates or suffer the financial consequences. As most CFOs are painfully aware, those consequences include substantial reductions in reimbursements.

By now, it is no surprise which states have said they won’t expand Medicaid as outlined under the Affordable Care Act. And while there are still a handful of states on the fence, it’s a given that states like Texas, Louisiana, Mississippi and Georgia, among others, were not going to budge.