Benchmark tool for revenue cycle automation finds some success
A just over one-year-old revenue cycle management benchmarking tool has been working well for two early adopters of the framework, called the Revenue Cycle Management Technology Adoption Model (RCMTAM). The Pennsylvania Mountains Healthcare Alliance (PMHA) and UC San Diego Health (UCSD) have used the model to gain more clarity on how their RCM operations are…
In pushing through restrictions on medical debt reporting, CFPB brushes off criticisms and concerns
Rebuffing apprehensions of healthcare providers and debt collectors, the Consumer Financial Protection Bureau (CFPB) published a final rule to block medical debt from appearing in a consumer’s credit history. As initially proposed in June, the regulations prohibit lenders from obtaining and using information about medical debt when determining a consumer’s credit eligibility (exceptions may include…
Texas Health Resources enhances self-scheduling with flexible options
Amid expected growth in demand from patients to schedule their own clinic visits, an Arlington, Texas-based health system learned that in practice some patients want more than just the ability to go online to choose a visit time, date and provider. Officials for Texas Health Resources (THR) found that out while implementing a new self-scheduling…
Medicare financial support for low-wage hospitals hits another roadblock in the courts
Plaintiff hospitals won a second consecutive appeals-court victory in the legal fight over Medicare’s low-wage-index policy. In December, the U.S. Court of Appeals for the Ninth Circuit upheld a district court’s ruling that the policy of increasing wage-index values for rural hospitals starting in 2020 was impermissible under the Medicare statute. The decision echoed a…
In surprise move, Biden administration terminates the Medicare Advantage Value-Based Insurance Design Model
A nearly decade-long effort to promote value-based insurance design (VBID) in Medicare Advantage (MA) will be discontinued after 2025, the Biden administration announced in December. The MA VBID Model has aimed to use health plan benefits design to encourage healthy behaviors and promote whole-person health among segments of beneficiaries. It began in 2017 and, after…
How regulatory shifts are shaping the future of revenue cycle operations
The healthcare industry is set for a major transformation, driven by government policies, legislative reforms, insurance updates and a continuous evolution of compliance and privacy standards that impact revenue cycle management (RCM). These developments present both challenges and opportunities for RCM teams but embracing them is crucial for healthcare organizations to thrive. Key regulatory changes…
Amid tight margins, MedPAC seems set to recommend an additional hospital payment boost
Hospitals have improved financially in the latest reporting period but still should receive a supplementary Medicare payment increase, according to a meeting of the Medicare Payment Advisory Commission (MedPAC). For 2026, Congress should authorize a 1% increase beyond the amount calculated using the statutory methodology, commissioners said during a December discussion. The notion is likely…
Final rules to support interoperability among healthcare stakeholders leave out key proposals
New regulations implemented by the Biden administration in December are designed to ease information-blocking compliance considerations for providers. Nonetheless, providers may be disappointed that technical provisions related to interoperability did not carry over from a wide-ranging proposed rule to a pair of streamlined final rules. Most notably, the finalized regulations exclude certification standards for application…
As data show a spike in spending on hospital services, new report lays out savings options
Accelerating hospital-focused expenditures helped spur a 2023 increase in national health spending, according to newly released data. Spending on hospital services surged by 10.4% for the year, up from a 3.2% increase in 2022 and 3.4% for the three-year period spanning 2020-22. The 2023 increase was the biggest seen since a 10.8% jump in 1990.…
Final bill ensures no loss of funding for Medicaid DSH payments, graduate medical education
The finalized continuing resolution (CR) to keep the federal government funded through mid-March includes key healthcare provisions. The bill that passed both chambers of Congress just before Friday night’s expiration of funding contained the same healthcare items as the version that failed to pass the House the day before. A key difference was the absence…