Claims Processing
Adverse events cost the healthcare industry billions of dollars. According to a 2010 report in the Archives of Internal Medicine, hospital-acquired sepsis and pneumonia in the United States caused more than 48,000 deaths and cost more than $8 billion to treat in a single year.
The proposed regulations for accountable care organizations released March 31 by the Department of Health and Human Services represent one of the first delivery-reform initiatives to be implemented under the Affordable Care Act.
The long-term care industry is one of the largest employers in the United States, yet its direct care workers are woefully underinsured, according to a new analysis.
A new face-to-face meeting requirement for home healthcare patients receiving Medicare has left some physicians and home healthcare groups disgruntled and industry experts shaking their heads at the idea that it will prevent fraud and waste.
The House Energy and Commerce Health Subcommittee is looking at ways to move beyond the Sustainable Growth Rate formula, the current method of paying Medicare physicians.
Recovery Audit Contractors (RACs) have identified $365.8 million in improper payments made to Medicare providers from October 2009 through March 2011. The payments were issued as long ago as three years prior to the dates on which they were identified by the RACs, marking the limit of the lookback period in which contractors were allowed to search.
A new study by the National Center for Policy Analysis shows that states and the federal government could save $33 billion in prescription medication costs by switching to models used by Medicare and other private payers.
There are significant issues and potential concerns that hospital-based practices should be aware of with respect to ICD-10 implementation. By preparing early however, practices can alleviate several operational and budgetary issues.
The Department of Health and Human Services has launched a new initiative that will reward hospitals for the quality of care they provide to Medicare beneficiaries. HHS officials said the program would also help reduce healthcare costs.
Enrollment in consumer-directed health plans grew by 22 percent in 2010, according to a study commissioned by the American Association of Preferred Provider Organizations.