Topics
Reimbursement
Healthcare groups prod Congress to stop CMS' payment cuts
Healthcare groups prod Congress to stop CMS' payment cuts
Revenue Cycle Management
The transactional revenue cycle no longer works: Here's what does
The transactional revenue cycle no longer works: Here's what does
Strategic Planning
Q&A with Geisinger CEO and president Dr. Jaewon Ryu, who will be CEO of the new Risant Health
Q&A with Geisinger CEO and president Dr. Jaewon Ryu
Capital Finance
Cash shortages plague hospitals but there are signs of improvement ahead
Cash shortages plague hospitals
Supply Chain
HIMSSCast: Embrace technology to replace the mundane tasks
HIMSSCast: Embrace technology to replace the mundane tasks
Accounting & Financial Management
Optum growth fuels strong quarter for UnitedHealth Group
Optum growth fuels strong quarter for UnitedHealth Group
Budgeting
Insurers likely to pay $1.1 billion in rebates this fall
Insurers likely to pay $1.1 billion in rebates this fall
Quality and Safety
U.S. News revises 'Best Hospitals' methodology in wake of backlash
U.S. News revises 'Best Hospitals' methodology in wake of backlash
Billing and Collections
Paying for healthcare creates mental and financial health concerns
Paying for care creates mental, financial concerns
Claims Processing
94% of physicians report care delays due to prior authorization, AMA says
94% of physicians report care delays due to prior authorization, AMA says
Workforce
AMA pushes to end noncompete clauses in physician contracts
AMA pushes to end noncompete clauses
Operations
Sola launches in growing employer self-funded health plan market
Sola launches in growing self-funded health plan market
Medical Devices
Humana teams with durable medical equipment organizations on home care
Humana teams with DME orgs on home care
Hospital/physician relations
Physicians would rather leave than work for Envision, doctor says
Physicians would rather leave than work for Envision, doctor says
Construction & Facilities Management
Providence announces $712 million expansion in southern California 
Providence announces $712M expansion in southern California 
Compliance & Legal
Florida men plead guilty to $67 million Medicare fraud scheme
Florida men plead guilty to $67 million Medicare fraud scheme
Policy and Legislation
CMS expanding Medicare Diabetes Prevention Program
CMS expanding Medicare Diabetes Prevention Program
Community Benefit
AMA and others launch collective call for health equity in Rise to Health
AMA and others launch collective call for health equity
Accountable Care
CMS is testing new primary care model
CMS is testing new primary care model
Acute Care
A cyberattack is partly to blame for St. Margaret's Health closing all operations
A cyberattack is partly to blame for St. Margaret's Health closing all operations
Ambulatory Care
Hospitals face direct competition from the 'retailization' of healthcare
Hospitals face direct competition from the 'retailization' of healthcare
Analytics
Top Stories: Patient information exposed in PharMerica breach
Top Stories: Patient information exposed in PharMerica breach
Business Intelligence
Healthcare job cuts increase 97% from 2022
Healthcare job cuts increase 97% from 2022
ICD-10 & Coding
Physician practices examine risk adjustment coding in wake of federal lawsuits
Practices keeping close watch on risk adjustment coding
Meaningful Use
CMS overhauls meaningful use EHR program, renames it 'Promoting Interoperability'
CMS overhauls meaningful use as 'Promoting Interoperability'
Medicare & Medicaid
Significant differences uncovered between MA, FFS enrollees
Significant differences uncovered between MA, FFS enrollees
Patient Engagement
Commercial health plan member satisfaction declining in key areas
Commercial health plan member satisfaction declining
Pharmacy
Pharmacy leaders meet with White House on Medicare prescription drug benefits
Pharmacy leaders meet with White House on Rx drug benefits
Population Health
One in four skip wellness appointments, regular checkups
One in four adults skip wellness appointments, regular checkups
Risk Management
UPMC for You partners to offer Medicaid redetermination coverage in laundromats
UPMC for You offers Medicaid redetermination coverage in laundromats
Telehealth
Telehealth linked to fewer in-person follow-up visits
Telehealth linked to fewer in-person follow-up visits
Mergers & Acquisitions
M&A activity returning to pre-pandemic levels
M&A activity returning to pre-pandemic levels
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ICD-10 & Coding

Hands work a calculator
Feb 01 | Susan Morse
Medicare Advantage plans get a proposed 1.03% payment increase in 2024
The Advance Notice with Proposed Payment Updates incorporates risk adjustment policies released earlier this week.
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Anthem rescinds reimbursement policy that would have cut payments
Feb 23, 2018 | Susan Morse
Anthem rescinds evaluation and management reimbursement policy to cut payments
The company had planned to reduce by 25 percent payments for evaluation and management services reported with…
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icd-11 World Health Organization
Dec 29, 2017 | Tom Sullivan
A 'gaming disorder' code in ICD-11? Not so fast
Even if the World Health Organization finalizes ICD-11 in May, it will take years for U.S. doctors to start using the next classification…
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Sep 25, 2017 | Jeff Lagasse
Physician practices examine risk adjustment coding in wake of federal lawsuits
Doctors need to carefully and properly use the HCC codes, which indicate the expected costs for a patient.
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ICD-10 codes get specific, and it matters for the bottom line
Sep 07, 2017 | Susan Morse
ICD-10 gets down to specifics, and attention to detail directly affects finances
This year, getting reimbursed is all about making sure the codes reflect the actual care given.
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Dec 14, 2016 | Beth Jones Sanborn
CMS waves Physician Quality Reporting System penalties for 2017, 2018 after massive ICD-10 update clogs system
"Eligible professionals" will submit eCQM data according to the 2015…
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Nov 16, 2016 | Susan Morse
Geisinger implements new HCC coding application to find gaps
Talix application analyzes member data from claims, electronic medical records and scanned paper documents to increase coding…
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Oct 03, 2016 | Susan Morse
ICD-10's first year was easy, but specificity has providers bracing for denials
Staffing and productivity issues remain, and with grace periods over, that could spell trouble.
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Sep 08, 2016 | Carl Natale
Tech firm launches contest to find the best ICD-10 coders
Central Learning will give $5,000 for the inpatient coder with the highest average accuracy and productivity scores across 10…
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Sep 06, 2016 | Jeff Lagasse
Mid-cycle losses have healthcare focusing on coding, predictive analytics to improve revenue cycle
Coding quality is more important than ever, but other analytics tools are helping hospitals…
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