Revenue Cycle News Update – April 18, 2019
Welcome to our second revenue cycle news roundup of April 2019. This regular feature showcases the most vital recent news stories in healthcare IT and revenue cycle management.
Here as always are the top stories since our last news roundup, as well as what you’ll need to know in the next few weeks.
Medicare / Medicaid News
Approximately 69 percent of federally qualified health centers in Medicaid expansion states were more likely to report financial stability and funding improvements since implementation of the Affordable Care Act (ACA).
The Government Accountability Office (GAO) placed Medicare and Medicaid on the list of programs at an elevated risk for fraud, waste, abuse and mismanagement after a recent investigation found $27.5 billion in Medicaid and Medicare improper payments due to insufficient documentation.
The Medicare Shared Savings Program (MSSP), dubbed Pathways to Success, will open on June 11. CMS overhauled the Medicare ACO program in late 2018, renaming it Pathways to Success. This program encourages ACOs to take financial responsibility for their patients.
Private Payer News
After leading the pack in 2018, healthcare is the lowest-performing S&P 500 sector thus far in 2019. Analysts claim this change is due to the threat of stricter regulation, which has negatively affected healthcare shares.
Now, more than ever, healthcare organizations recognize the importance of receiving prompt payment from consumers receiving healthcare services. We can help.
As healthcare costs rise and more consumers have high-deductible health plans, many Americans wait until after they receive their tax refund to pay for their medical care. Consumers’ out-of-pocket healthcare spending was up by 60 percent in the first week after their received their refunds, and spending continued for approximately 75 days afterward, which was a 20 percent increase.
According to a new study, healthcare providers must build alternative revenue sources into their long-term strategies to fuel growth. This comes amidst downward revenue pressure and experts warn there’s no one-size-fits-all approach.
A short-term solution is to ensure you are getting paid promptly, or getting paid at all. This is often as simple as making sure you know your patient’s benefits up front.
Upcoming Revenue Cycle Events
We’d love to talk! Here’s where to find us over the next few months:
April 24-26, 2019
St. Louis, MO
Wisconsin Dells, WI