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Managed Care Contracting & Reimbursement Advisor, May 2013

Former Senate Majority Leader Bill Frist, MD, a Republican and heart surgeon from Tennessee, is leading a coalition of physicians who are calling for the federal government to phase out the...

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DOJ and HHS announce record-breaking recoveries from fight against fraud

For every dollar spent on healthcare-related fraud and abuse investigations in the past three years, the government recovered $7.90, according to an announcement by U.S. Attorney General Eric Holder...

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HHS announces 2013 agenda to bring down costs, improve quality of care

The government wants to see 50% of physician offices using electronic health records (EHR) by the end of 2013, according to a plan announced recently by CMS Acting Administrator Marilyn Tavenner and...

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Electronic records could cost you money instead of improving revenue

Several recent reports cast doubt on the potential benefits of adopting electronic health records (EHR), noting that the financial benefits and practical application of the systems may not be all that...

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Internists issue plan to improve healthcare system, end 'assault' on...

The American College of Physicians (ACP) is calling for a significant change to how healthcare is provided in the United States, particularly with regard to what it says are barriers to a productive...

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Doctors, congressmen call for end to fee-for-service

Former Senate Majority Leader Bill Frist, MD, a Republican and heart surgeon from Tennessee, is leading a coalition of physicians who are calling for the federal government to phase out the...

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Managed Care Contracting & Reimbursement Advisor, June 2013

The changes associated with the Affordable Care Act (ACA), electronic medical record (EMR) implementation, and new Medicare rules mean that physician practices are under increasing pressure, says Nancy...

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CMS and California partner to coordinate care for Medicare-Medicaid enrollees

HHS announced recently that the state of Cali­fornia will partner with CMS to test a new model for providing Medicare-Medicaid enrollees with a more coordinated, person-centered care experience, along...

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HHS finalizes rule guaranteeing 100% funding for new Medicaid beneficiaries

HHS Secretary ­Kathleen Sebelius recently announced a final rule with a request for comments that provides, effective January 1, 2014, the federal government will pay 100% of the cost of certain newly...

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CurrentCare is first statewide HIE to exchange behavioral health data

CurrentCare, Rhode Island's Health Information Exchange, is the first statewide HIE in the nation to exchange behavioral health data electronically. The Providence Center and Gateway Healthcare, Inc.,...

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Production not only influence on compensation levels for physicians in...

Research has indicated that three primary activities influence physician compensation in academic settings: clinical effort, teaching, and research. In contrast, physicians working in other settings...

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Reader question: How to use 'bill above' in reimbursement coding

Q. Are you familiar with the term "bill above" in ­reimbursement coding? My understanding is that services categorized as "bill above" are reimbursed for that service in addition to a capitated rate...

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Physician group uses new strategies to improverevenue

A private, nonprofit hospital physician group located in the Southern United States recently sought help from Nancy Ruff, director of health advisory services, and her colleagues at CTG Health...

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Revenue optimization more challenging than ever before

The changes associated with the Affordable Care Act (ACA), electronic medical record (EMR) implementation, and new Medicare rules mean that physician practices are under increasing pressure, says Nancy...

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Managed Care Contracting & Reimbursement Advisor, July 2013

Physician practices are beginning to feel the changes in managed care forced by the Affordable Care Act (ACA), and many are looking for ways to stay profitable as the payer landscape shifts. In the...

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Compensation on rise, but more focus on quality for physicians

Primary care physicians reported $180,000 in median first-year guaranteed compensation, up from $175,000 in 2011, according to the MGMA's Physician Placement Starting Salary Survey: 2013 Report Based...

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ACOs will change the way you practice medicine, how you get paid

Physicians are nervous about transitioning to the accountable care organization (ACO) model because it completely changes the way they get paid, says V. "Juggy" Jagannathan, vice president of research...

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Kaizen method helps multispecialty practice improve numbers in a big way

One of the nation's biggest multispecialty practice management companies is finding that the kaizen method of continuous quality improvement can create greater efficiencies and enhance revenue at just...

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Referral paths will be all-important when deciding future path for your practice

How should physician practices respond to the changing face of healthcare? The first imperative is maintaining a place in the referral path, says Marc ­Halley, president and CEO of Halley Consulting...

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ACA prompting managed care changes, physicians scrambling to respond

Physician practices are beginning to feel the changes in managed care forced by the Affordable Care Act (ACA), and many are looking for ways to stay profitable as the payer landscape shifts. In the...

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