HIT Consultant

MARCH 11, 2025

– The solution aims to help Medicare Advantage plans improve their TRC Star measure performance by automating the access and delivery of critical admission and discharge information. The new solution addresses the significant issue of hospital readmissions among Medicare beneficiaries. billion annually.

Medicare 99

Medicare Medicare Medicaid Medicaid 99

Healthcare Dive

MAY 23, 2022

The hospital lobby is pushing the Justice Department to go beyond the recommendations in a new report from the HHS OIG and punish Medicare Advantage organizations that routinely deny coverage to beneficiaries.

Medicare 284

Medicare Medicare Hospitals 284

HealthIT Answers

APRIL 13, 2025

By Arielle Zionts - Rural hospital leaders are questioning whether they can continue to afford to do business with Medicare Advantage companies, and some say the only way to maintain services and protect patients is to end their contracts with the private insurers.

Medicare 59

Medicare Medicare Hospitals 59

Healthcare Dive

OCTOBER 31, 2024

Citrus ACO in Central West Florida had the highest savings rate, while Health Connect Partners — an ACO operated by hospital giant Providence — had the highest total savings in the Medicare Shared Savings Program last year.

Medicare 249

Medicare Medicare Hospitals 249

Healthcare Dive

JUNE 27, 2022

The highest court upheld HHS' method of calculating Medicare payments to hospitals serving a high proportion of low-income patients, rebutting hospitals’ efforts to recoup potentially billions of dollars from the program.

Medicare 274

Medicare Medicare Hospitals 274

Healthcare Dive

NOVEMBER 29, 2022

Hospitals must effectively mitigate risks to ensure patients and staff are safe as part of their Medicare certification, the agency said in a Monday memo, noting that some facilities have received citations for failing to do so.

Hospitals 301

Hospitals Medicare Medicare 301

Healthcare Dive

AUGUST 2, 2024

Hospitals still weren’t happy with the final rule despite the bump from the CMS’ proposed rates, citing cuts to long-term and disproportionate share facilities.

Medicare 317

Medicare Medicare Hospitals 317

HIT Consultant

DECEMBER 23, 2024

Brian Norris, Managing Director of Strategic Consulting at MedeAnalytics There are almost 33 million people enrolled in eligible Medicare programs. Nearly half are enrolled in Medicare Advantage (MA) plans, and that number is expected to continue its climb.

Health Outcomes 97

Health Outcomes Medicare Medicare Patient Satisfaction 97

Healthcare It News

JANUARY 23, 2025

As healthcare continues to advance with accountable care organizations and value-based care models, the industry is starting to see some real traction after a decade of groundwork in the form of CMS claims for the Medicare Shared Savings Program. There are some critical elements driving success here.

Medicare 309

Medicare Medicare Hospitals Doctors 309

Healthcare Dive

APRIL 17, 2024

Independent practices have clearer financial incentives to lower medical spending than hospitals participating in accountable care organizations, according to the Congressional Budget Office.

Medicare 355

Medicare Medicare Hospitals 355

Healthcare Dive

APRIL 14, 2025

The American Hospital Association slammed it as inadequate. The rate increase is the lowest since 2019.

Hospitals 175

Hospitals Medicare Medicare 175

Healthcare Dive

JUNE 13, 2022

Though it’s tempting to interpret the recent Medicare trustees report as good news, academics are arguing lawmakers can’t wait until hospital trust fund insolvency is imminent before taking action to bolster the program.

Medicare 246

Medicare Medicare Hospitals 246

Medisys Compliance

MARCH 9, 2025

Understanding Medicare coverage for counseling can feel particularly challenging, but it is crucial. Many providers find themselves asking: What exactly does Medicare cover when it comes to outpatient mental health counseling services? This cornerstone of outpatient mental health care is generally well-covered by Medicare.

Medicare 59

Medicare Medicare Medical Billing Medical Billing Services 59

Fierce Healthcare

MAY 13, 2024

The gap between insurance plans and Medicare's payments to hospitals for inpatient and outpatient services widened over the course of just a couple of years, a new study from RAND Corporation | A new report from RAND Corporation highlighted just how much more employers and private insurers are paying hospitals for inpatient and outpatient services. (..)

Medicare 134

Medicare Medicare Hospitals 134

Healthcare IT Today

APRIL 4, 2025

Translation of member materials is an onerous burden for Medicare Advantage Organizations (MAOs). For Dual Special Needs Plans (DSNPs), compliance is even more complex as they must meet both Medicare and Medicaid translation requirements, supporting as many as 24 languages in some states.

Medicare 84

Medicare Medicare Medicaid Medicaid 84

Healthcare Dive

OCTOBER 27, 2023

The Health Resources and Services Administration is once again requiring hospitals to register outpatient clinics and list them on Medicare cost reports, setting a higher bar for eligibility in the drug discount program.

Hospitals 209

Hospitals Medicare Medicare 209

Fierce Healthcare

NOVEMBER 4, 2024

R-Louisiana, and Maggie Hassan, D-New Hampshire, published a policy paper advocating to impose site-neutral Medicare payments on hospitals. | The lawmakers argue that site-neutral Medicare payment reform would lead to lower healthcare costs for patients and save taxpayer dollars. Senators Bill Cassidy, M.D.,

Medicare 122

Medicare Medicare Hospitals 122

Fierce Healthcare

AUGUST 20, 2024

The upward trajectory of Medicare Advantage (MA) enrollment is likely to become an issue for hospitals and other healthcare providers forced to contend with plans’ prior authorization requirements | Prior authorization burdens and "a challenging contract negotiation season" on the horizon are likely headwinds for providers, and hospitals (..)

Medicare 131

Medicare Medicare Hospitals 131

Healthcare Dive

FEBRUARY 21, 2024

The research found no differences in 30-day hospital readmissions or mortality, but the study’s authors said more analysis on patients’ long-term functioning was needed.

Medicare 274

Medicare Medicare Hospitals 274

Fierce Healthcare

MAY 6, 2024

The Hospital Insurance Trust Fund will be fully solvent for longer than previously projected, according to an annual Medicare Trustee report. | The Medicare Hospital Insurance Trust Fund won't run out of money as quickly as expected. Here's how federal officials are reacting.

Medicare 126

Medicare Medicare Hospitals 126

Healthcare IT News - Telehealth

MARCH 4, 2021

Retain important “Hospital without Walls” site of care flexibility to support home-based hospital services. Encourage greater flexibility for home-based care services to meet commercial and Medicare Advantage network adequacy standards. Advocate for a bundled-payment model for extended care in the home.

Hospitals 216

Hospitals Medicare Medicare COVID-19 216

Fierce Healthcare

NOVEMBER 3, 2024

Under a final rule issued by the Centers for Medicare and Medicaid Services, outpatient hospital facilities and ambulatory surgical centers will get a 2.9% Medicare pay increase next year, up from | Under a final rule issued by CMS, outpatient hospital facilities and ambulatory surgical centers will get a 2.9%

Medicare 126

Medicare Medicare Medicaid Medicaid 126

Healthcare Dive

NOVEMBER 9, 2023

New research from Harvard and Inovalon found MA beneficiaries had fewer hospital readmissions, fewer preventable hospitalizations and lower rates of high-risk medication use than those in traditional Medicare.

Health Outcomes 167

Health Outcomes Medicare Medicare Hospitals 167

Healthcare Dive

DECEMBER 7, 2022

The hospital lobby is asking Congress to establish a temporary per diem Medicare payment to help ease healthcare capacity issues.

Health Outcomes 317

Health Outcomes Medicare Medicare Hospitals 317

Healthcare Dive

APRIL 27, 2023

Political will appears to be rising to equalize Medicare payments to hospitals and doctor’s offices for certain low-acuity services, according to lawmaker comments during a Wednesday hearing.

Doctors 321

Doctors Medicare Medicare Hospitals 321

Fierce Healthcare

AUGUST 1, 2024

The Bipartisan Policy Center released a report on Wednesday that recommends that C | The Bipartisan Policy Center released a report on Wednesday that recommends Congress extend the Medicare Acute Hospital Care at Home waiver for five years to increase uptake.

Medicare 128

Medicare Medicare Hospitals 128

Healthcare IT News - Telehealth

MAY 14, 2021

Mayo Clinic and Kaiser Permanente announced this week that they will collaborate to build capacity for hospital-at-home care. Technology aimed at blurring the lines between at-home care and in-hospital services has taken on a renewed spotlight amidst the COVID-19 pandemic, when patients and providers have sought to avoid potential spread.

Hospitals 214

Hospitals COVID-19 Medicaid Medicaid 214

Healthcare Blog

JANUARY 19, 2025

CMS Medicare Swing Bed Rules and Regulations for Critical Access Hospitals (CAHs) Critical Access Hospitals (CAHs) are the backbone of rural healthcare, providing essential services to underserved communities. This flexibility benefits both the hospital and the patient. Prevent fraud and abuse of Medicare funds.

Medicare 52

Medicare Medicare Compliance Nurses 52

Fierce Healthcare

APRIL 3, 2024

The program, and its complementary effort targeting manufacturers, would require new authorities from Congress.

Medicare 118

Medicare Medicare Hospitals 118

Healthcare Dive

JUNE 16, 2023

The group that advises Congress on Medicare policy also suggested more closely setting payment rates across outpatient facilities for some services, which hospital lobbyists oppose.

Medicare 293

Medicare Medicare Hospitals 293

MRO Compliance

FEBRUARY 3, 2025

Below are three key steps health systems, hospitals, and physician practices should take to effectively prepare for the upcoming HEDIS season. HEDIS audits are important for Medicare and Medicaid health plans because data is used to determine the efficacy of a payer to care for its members.

Patient Satisfaction 147

Patient Satisfaction Compliance Medicare Medicare 147

Healthcare Dive

JUNE 2, 2023

The Department of Justice alleged two DMC hospitals offered the services of mid-level practitioners to physicians in exchange for Medicare patient referrals.

Medicare 284

Medicare Medicare Hospitals 284

Healthcare IT News - Telehealth

DECEMBER 7, 2021

American Hospital Association. We owe it to our patients to make health care access easier, and patients with Medicare should not be excluded from this opportunity," said Dr. Brian Hasselfeld, medical director of digital health and telemedicine at Johns Hopkins Medicine, in a statement. Alliance for Connected Care. Athenahealth.

COVID-19 214

COVID-19 Hospitals Telemedicine Medicare 214

Healthcare IT News - Telehealth

MARCH 23, 2021

Now more hospitals and health systems are looking to expand their efforts beyond video visit-based virtual care, and push for expanded remote patient monitoring programs – up to and including the provision of acute care at home. Telehealth proved its mettle this past year. And then the big one being the waiver that came out in November.

Hospitals 217

Hospitals COVID-19 Medicare Medicare 217

HealthIT Answers

JANUARY 15, 2025

The Hospital Quality Reporting System is now open and accepting calendar year 2024 Medicare Promoting Interoperability Program data submissions and attestations from eligible hospitals and critical access hospitals. The post HQR System Now Accepting CY 2024 Medicare PI Program Data appeared first on Health IT Answers.

Medicare 59

Medicare Medicare Hospitals 59

Healthcare IT News - Telehealth

APRIL 3, 2024

Hospital patients with conditions like pneumonia, dehydration and heart failure have been shown to experience shorter recovery times with fewer complications when they receive more cost-effective healthcare at home – and many health systems have been preparing for this future.

Hospitals 189

Hospitals Medicaid Medicaid Medicare 189

Medisys Compliance

FEBRUARY 19, 2025

Billing Update: Medicare Radiology Reimbursement Cuts 2025 Effective January 2025, radiology practices nationwide are facing reduced Medicare reimbursements due to finalized changes in the Physician Fee Schedule. Now, in February 2025, these proposed rules are our current reality. Here are key steps you can take: 1.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Medical Billing 59