Healthcare

‘Significant Ramifications’: Medical Group Opposes HCC Coding Changes

By Amanda Norris for Health Leaders CMS recently released proposed changes to the CMS-HCC Risk Adjustment Model for payment year 2024 in February, with a public comment period that ending surprisingly quick. These changes will directly affect Medicare Advantage organizations as the model informs payments to Medicare Advantage plans. “The proposed changes (Model V28) would make significant changes to…

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5 Rev Cycle Strategies to Combat Denials

By Jasmin Ray for Health Leaders Executives are reporting an increase in denials, putting more pressure on system finances. Going back and forth with payers with denials is a time consuming and expensive process, and low reimbursement rates aren’t helping. In a new survey by the Healthcare Financial Management Association, CFOs noted a significant increase in denials,…

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There’s no denying RCM teams’ top challenges

By Andrew Cass for Becker’s Hospital Review Eighty-two percent of health system CFOs said that payer denials are higher than pre-pandemic levels, compared to only 2% who say denials have decreased, according to a report from the Healthcare Financial Management Association and Eliciting Insights.  “HFMA Health System CFO Pain Points 2024” is based on a…

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6 systems creating new C-suite roles

By Mackenzie Bean for Becker’s Hospital Review Health systems’ leadership benches have expanded in the last year, as new executive titles make their way to C-suites in response to changing industry dynamics and emerging challenges. Nearly two months into 2024, this trend shows no signs of abating. At least six health systems have appointed leaders to inaugural C-suite positions…

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Physicians report 15 hours of ‘pajama time’

By Andrea Fox for Healthcare IT News Some 93% of physicians feel burned out, but 83% said AI has the potential to reduce administrative burdens, according to athenahealth’s third Physician Sentiment Survey, conducted by the Harris Poll. For this year’s measurement of physician sentiments, atheneahealth added a new line of questioning focused on artificial intelligence…

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Hospitals see expense relief

Laura Dyrda for Becker’s Hospital Review Nonprofit hospital expenses dropped from November to December and had low single digit growth year over year, according to Kaufman Hall’s “National Hospital Flash Report,” released Jan. 30. The data shows overall expenses per calendar day declined 2% month over month and grew 4% year over year in December,…

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15 CMS updates to know in 2024

By Paige Haeffele for Becker’s Hospital Review Healthcare is an ever-changing industry, and in 2023, CMS made notable changes — some lauded, some contested. CMS policies affect many issues healthcare leaders and physicians are most passionate about, such as reimbursement and practice capabilities. Here are 15 policy changes made by CMS last year to know…

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A CIO looks back on 2023, and offers a forecast for 2024

By Mike Restuccia for Healthcare IT News It’s that time of year, to reflect again on the past and pontificate about what the future may hold for the healthcare information technology community. For the first time in several years, I’m promoting a more positive, albeit cautious, message. Like the “revenge travel” explosion seen as individuals broke free from the…

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CMS Ups Reimbursement For Certain SDOH Codes

By Amanda Norris for Health Leaders Media CMS recently released the fiscal year (FY) 2024 Inpatient Prospective Payment System (IPPS) final rule. Along with its yearly payment rate changes, the final rule placed a focus on promoting high-quality care and rewarding hospitals that deliver such care to underserved populations. Notably, CMS finalized a higher severity level designation for…

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