Electronic Health Records

Medicare Reimbursement

Congress agrees on framework to replace Medicare SGR

by Jennifer Bresnick

Physicians may have another reason to celebrate at their New Year’s Eve parties this year: the abolition of the annual January 1 anxiety over the Medicare sustainable growth rate (SGR).  The Senate Finance and House Ways and Means...

Where is the revenue cycle in health IT, healthcare reform?

by Sponsored Content

It doesn’t really matter what your company chooses to call it — returns, income, proceeds, profits, moolah, or revenue — the fact remains that whatever the term used, the effective management of “it” is the key to your health...

Medicare SGR repeal could cost feds $175 billion

by Jennifer Bresnick

Repealing the reviled Medicare Sustainable Growth Rate (SGR) formula will cost big bucks for the federal government, says the Congressional Budget Office.  Direct federal spending will go up about $175 billion between 2014 and 2023 if the...

OIG: Medicare RACs aren’t taking proper action to combat fraud

by Jennifer Bresnick

Medicare’s recovery audit contractors (RACs) could be doing a better job to identify, eliminate, and follow up on fraud and improper billings, says a new report by the Office of the Inspector General (OIG).  While RACs identified $1.3...

Study: Top hospitals paid 60% more than cheaper competitors

by Jennifer Bresnick

Whether it’s an emergency situation or an elective procedure, most patients don’t feel that they have much of a choice when it comes to the hospital where they receive care.  Expecting to cringe at the bill that comes in the mail is a...

AHA survey: Medicare RAC audits up 47% since last year

by Jennifer Bresnick

The number of Recovery Audit Contraction (RAC) requests for medical claims reviews has increased “dramatically” since 2012, according to the American Hospital Association’s (AHA) newest RACTrac survey.  More than...

Study: Single-payer healthcare system could save trillions

by Jennifer Bresnick

When it comes to radical healthcare reform, the Affordable Care Act (ACA) is small potatoes.  A new study by Gerald Friedman, PhD, an economics professor at UMASS Amherst, believes that if everyone used Medicare – and only Medicare –...

Is the Medicare SGR reform a victory for accountable care?

by Jennifer Bresnick

The bipartisan legislation that would do away with the annual anxiety over the Medicare sustainable growth rate (SGR) system has attracted praise and criticism from politicians and physicians alike.  While the repeal of the flawed SGR...

Medicare, private payer accuracy up, but patient costs reach 25%

by Jennifer Bresnick

Medicare and private payers are paying out claims faster, more accurately, and more electronically than ever before, according to a new report by the American Medical Association (AMA), but patients are now responsible for an average of...

Senators call for greater Medicare claims data transparency

by Kyle Murphy, PhD

Apparently, recent attempts by agencies within the Department of Health & Human Services (HHS) to increase transparency haven’t done enough to satisfy two members of Congress. In a joint statement issued yesterday, Senators...

Cash over quality: Medicare pays 190% more for faulty surgeries

by Jennifer Bresnick

“Quality” is a word that gets tossed around a lot in discussions about EHR adoption, payment model reforms, and patient safety initiatives.  After all, the goal of health IT is to improve the quality of care by reducing poor outcomes,...

Ophthalmologists rally against sequester cuts to Medicare

by Jennifer Bresnick

Nearly four hundred members of the American Academy of Ophthalmologists (AAO) came together on Capitol Hill today in order to express their worries over the 2% cuts to Medicare reimbursements.  With many common eye diseases, including...

Cancer clinics denying Medicare patients due to sequester

by Jennifer Bresnick

April may be National Cancer Control Month, but thousands of Medicare patients suffering from the disease are finding themselves turned away from community clinics due to the expensive treatments they need, with providers blaming the 2%...

AHA on Medicare Cuts: Don’t Do More with Less, Just Do Better

by Jennifer Bresnick

Richard Umbdenstock, CEO of the American Hospital Association (AHA), addressed falling hospital reimbursements tied to a slashed Medicare budget and upcoming sequestration cuts in Nashville this week, urging hospitals to make the most of...

Medicare payments dodge fiscal cliff bullet with last-minute deal

by Jennifer Bresnick

A down-to-the-wire vote by the House of Representatives successfully averted the 28.5% cut in Medicare reimbursements that would have been part of the nation’s plunge over the fiscal cliff.  The bill, which cleared the Senate easily but...

Medicare billing increases in EDs with EHRs: fraud or sicker patients?

by Jennifer Bresnick

Billing fraud has been a top concern for the Centers for Medicare and Medicaid Services (CMS) and the Government Accountability Office (GAO) since the widespread adoption of EHRs began.  Worried about the possibility of physicians...

Medicare payments set to take a tumble over the “fiscal cliff”

by Jennifer Bresnick

The end of 2012 is approaching quickly, and politicians have yet to resolve budgetary issues that will have a significant effect on Medicare reimbursements for qualified physicians.  Known as the “fiscal cliff”, the package of...

AHA sues HHS for refusal to pay millions in valid Medicare claims

by Jennifer Bresnick

The American Hospital Association (AHA), in conjunction with Missouri Baptist Sullivan Hospital, Lancaster General Hospital, Trinity Health Corporation, and Munson Medical Center, has brought a lawsuit against the Department of Health and...



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