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Payment reform: Flat facility fees and ACOs aren't enough
Health Affairs
American hospitals are expensive. Reams of data show that hospital-based services are more expensive than the same services provided in other settings. The explosive growth of hospital costs is one of the key culprits in the nation's high healthcare spending. Nonetheless, attempts to reform hospital payment methodologies are usually greeted with fierce criticism from the industry. The latest clash, which stems from a CMS proposal to consolidate facility fees, offers an opportunity to review why hospitals are so expensive, to detail some of the larger issues with hospital billing practices and how they contribute to increasing healthcare costs, and to explore some ideas for reform.
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CMS finalizes integrity rules for PPACA exchanges
Becker's Hospital Review
CMS has finalized policies from a proposed rule concerning the program integrity of the Patient Protection and Affordable Care Act health insurance exchanges. The final rule focuses on integrity standards for cost-sharing reductions, premium stabilization programs, advance payments of premium tax credits, state marketplaces, oversight of insurers offering coverage through federally facilitated marketplaces and standards for HHS-approved enrollee satisfaction survey vendors.
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Webinar: 'CRCP, The Certified Revenue Cycle Professional'
AAHAM
Topic: CRCP, The Certified Revenue Cycle Professional

When: Wednesday, Nov. 13, Dec. 11 or Jan. 8 noon - 12:30 p.m. EDT

Speakers: AAHAM President Elect, Victoria DiTomaso, CRCE-I and AAHAM Second Vice President, John Currier, CRCE-I

Join us to learn all about the newest AAHAM certification, the Certified Revenue Cycle Professional. Find out about who should take this exam, the format, costs and what it means to your career development. There will also time to answer your questions!

We are offering this FREE webinar on three different dates to make it accessible to all of you! Choose Nov. 13, Dec. 11 or Jan. 8.

Click here to download the full description and printable order form.

Click here to register online.

Everyone earns 1 CEU for attending

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PRODUCT SHOWCASE
  Webcast November 8th 1-2PM Central

How Patient Access Automation and Process Improvements Drove Revenue Cycle Results at Health First

POS Collections up 30%, Bad Debt Write-Offs down 41%, and A/R Days down 15% through automated processes and comprehensive benefits advising for all patients. Presenters - Michelle Fox, Health First, and Paul Shorrosh, AccuReg.

 


ICD-10-CM from an optimistic coder's perspective
By Elizabeth Morgenroth
In my discussions with coders in the past 18 months, I have found that each coder has a reaction to ICD-10-CM as unique as the person expressing it. The emotions associated with ICD-10-CM cover the complete spectrum — from joy to grief, happiness to rage, doubt to certainty. I have experienced each of these emotions, depending on the subject matter and situation.
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EHR adoption is both a disruption and an opportunity
EHR Intelligence
Electronic health records can be an overwhelming topic for the medical community because it seems so big and complex. But adopting an EHR system is actually a great disruptive opportunity, one that can help the industry to advance systems interoperability, reinvigorate business and enhance the patient relationship. Many practices are doing a fantastic job incorporating EHRs into their practices. Of course, others still need some help to get going.
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Looking for similar articles? Search here, keyword(s): Seizing an opportunity.




5 things to know about omnibus HIPAA enforcement
Government Health IT
The omnibus rule, which kicked in a little over a month ago, establishes a new set of expectations and possibilities on the enforcement front. HIPAA provisions now apply to Business Associates, creating new accountabilities for vendors doing business with healthcare, which increases the Office for Civil Rights flexibility in pursuing formal action, and provides for an expanded set of subjective criteria for determining fines. It is not likely to dramatically change OCR's approach to enforcement, however, or the office's commitment to the protection of patient information through appropriate compliance as the primary goal of its enforcement activities.
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FEATURED ARTICLE
TRENDING ARTICLE
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Nurse staffing linked to lower readmission penalties
HealthLeaders Media
According to a study, the better staffed a hospital is with nurses, the lower its odds of being slapped with readmission penalties.

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AAHAM announces name changes to their renowned certifications
AAHAM
The new AAHAM designations now accurately reflect the scope of knowledge and skills required to secure these prestigious certifications.

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5 opportunities for improving hospital RCM
Healthcare Finance News
With hospital margins growing tighter and bad debt increasing, improving revenue cycle becomes more important than ever.

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The trouble with pay-for-performance
HealthLeaders Media
Payers have tried to imparting some performance expectations and measurement tools into healthcare payment through so-called pay for performance programs that offer incentives for following certain processes that have been proven to add value, and they should make a difference, as logic dictates. The problem, says the author of a study on pay for performance, is that this kind of logic may not apply in healthcare, at least not at the levels currently in place.
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Common ICD-10 errors for hospital coders to watch for
Becker's Hospital Review
The Healthcare Information and Management Systems Society and Workgroup for Electronic Data Interchange recently released a report on its ICD-10 national pilot program, and the groups found many errors existed in the transition to the new coding system. Only 63 percent of ICD-10 codes were accurate, and some errors were more prevalent than others. The following are seven common ICD-10 errors that HIMSS and WEDI highlighted in their report.
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Medicaid ACOs accounting for challenges
Health Data Management
The much-ballyhooed model of care delivery known as the accountable care organization, or ACO, is moving front and center in the industry. ACOs have emerged in many different flavors, in both the commercial and public sectors. In the latter, the Medicaid ACO is tackling one of the industry's most difficult population groups — the poor and the underserved. And Medicaid recipients themselves — a diverse mix of young, old, disabled and low-income people who now number about 60 million nationwide — face challenges rarely imagined by the more affluent population.
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Study: Hospitals maneuver financial operations to adopt full scale outsourcing
PRWeb
Nationally, 50 hospitals each month are turning their complete revenue cycle management operations over to external suppliers and the trend is escalating. Black Book polls found that outsourcers' focused initiatives on billing and collection processes are also impacting patient satisfaction hospital-wide in clinical services and perceptions of quality of care.
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TRENDING ARTICLES
Missed last week's issue? See which articles your colleagues read most.

    5 opportunities for improving hospital revenue cycle management (Healthcare Finance News)
4 best practices for RCM system replacement (Becker's Hospital Review)
Efforts to reduce waste in healthcare lead to job loss for many (Pamela Lewis Dolan)
To encrypt or not to encrypt: Is that the question? (Government Health IT)

Don't be left behind. Click here to see what else you missed.


 

AAHAM eNewswatch
Colby Horton, Vice President of Publishing, 469.420.2601
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Lisa Smith, Senior Content Editor, 469.420.2644  
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