Policy and Legislation
A U.S. Census report released this week showed that the ranks of uninsured shrank for the first time since 2007 dropping to 15.7 percent of the population compared with 16.3 percent in 2010 and a separate report showed average insurance rates increased only 4 percent in 2012.
The U.S. Supreme Court’s decision on the Patient Protection and Affordable Care Act has brought much-needed clarity to hospitals and other healthcare providers. With the uncertainty gone, providers can now fully assess and plan for the Affordable Care Act’s effect on revenue cycle management.
New Institute of Medicine report identifies four tools that will improve care and lower costs in the healthcare system: computing power, connectivity, improved organizational capabilities and teamwork.
New York Downtown Hospital will pay a total of $13.4 million in a Medicare and Medicaid fraud settlement that alleged the hospital received claims on an unlicensed inpatient drug detox program and that it paid kickbacks to an out-of-state vendor for referrals to the program.
After the Centers for Medicare & Medicaid Services denied Maine an expedited review for its $20 million Medicaid reduction plans, the state's attorney general is seeking a federal court review to prompt a decision.
Some people are motivated by incentives, but almost everyone hates to lose. So the penalty phase provides a motivation to get moving, even to those providers who missed out on the bonuses.
Nearly every healthcare organization and affiliated clinician group faces challenges when working to meet new models of care and payment delivery. One industry expert offers six pieces of advice to lower costs, improve care and maximize revenue in the ED.
Even as many states gear up for tougher insurance regulations under the federal health law, Maine lawmakers last year bucked the trend, loosening rules they blamed for some of the highest premiums in the nation.
According to the latest RACTrac survey by the American Hospital Association (AHA), Medicare recovery auditors (RAC)-related denials in the second quarter of 2012 soared upwards by 24 percent from the first quarter of 2012.
As states across the country work to expand Medicaid and build health insurance exchanges, one challenge they will surely face is fraud.