Cuts to ACA Haven’t Deterred Consumers

Recently, federal funds that assist Americans signing up for health insurance coverage under the Affordable Care Act (ACA) were cut by 40 percent and the ACA advertising budget was slashed from $100 million to $10 million.These moves demonstrate the determination of the current administration and many in Congress to minimize the ACA insurance marke...
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Opioids a National Public Health Emergency: A Presidential Declaration, a Comprehensive Report

Following on the heels of President Trump's declaration of the opioid epidemic as a national public health emergency, the president's commission on the opioid crisis last week issued its final reportcontaining more than 50 recommendations for addressing what has been called the most serious drug problem in U.S. history. The report, the heightened f...
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Consumers Expect More from their Healthcare Experience as Payment Responsibility Rises

​The level of respect, compassion and sensitivity to healthcare consumers is increasingly being used to judge patient satisfaction regarding quality of care and is an important component of a healthcare system's care delivery.There is an increasing focus on encouraging individuals to be more involved in their care, which has prompted providers to d...
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A Refresher for Healthcare Providers on Business Associate Agreements: Are Your Contracts in Order?

Under the HIPAA Omnibus Rule, failure to have written business associate agreements in place can lead to sizable fines and penalties for covered entities. In 2015, for example, Raleigh Orthopaedic Clinic, PA, of North Carolina paid $750,000 to settle charges that it potentially violated the HIPAA Privacy Rule by sharing patient protected health inf...
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Impending Disproportionate-Share Hospital Payment Reductions Threaten Safety-Net Hospitals’ Finances

​Safety-net hospitals rely on disproportionate-share hospital (DSH) payments to help cover uncompensated care costs and underpayments by Medicaid. The Affordable Care Act (ACA) anticipated that insurance expansion would increase safety-net hospitals' revenues and planned to reduce DSH payments accordingly.However, decreases in uncompensated care co...
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Hospitals Take on ‘Food Insecurity’ to Impact Population Health

As healthcare delivery shifts toward population health management, hospitals and health systems are beginning to understand—and take steps to address—the connections between a wide range of socioeconomic factors and the health and well-being of the communities they serve. One of these factors is "food insecurity," which the U.S. Department of Agric...
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Final Two Deadlines Loom for Medicare Quality Payment Program

The Medicare Quality Payment Program (QPP) began on January 1, 2017, and required that eligible physicians and certain non-physician practitioners participate in either the Merit-Based Incentive Payment System (MIPS) or an advanced Alternative Payment Model (APM). MIPS-eligible clinicians who do not participate in either track in 2017 will receive ...
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OIG Zeroes in on Opioid Misuse, Abuse, Diversion and Fraud

Addiction experts report that the opioid epidemic is shifting more to the illicit trade of heroin and fentanyl. However, that doesn't diminish the central role that prescription painkillers continue to play in this public health crisis. Nor does it diminish the responsibility of physicians, nurse practitioners, physician assistants and healthcare f...
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How Has Natural Language Processing Technology Changed Healthcare?

When you search on your smartphone for something by saying "OK Google," or call on iPhone's Siri for assistance, or ask Amazon's Alexa for help, the system knows that "CA" means "California." But when you search for something on SharePoint, or in a clinical record, or even across multiple systems, does the system recognize the intent of your search...
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Emergency Waivers Help Providers Care for Hurricane-Affected Patients

Healthcare providers, if you serve Medicare, Medicaid and Children's Health Insurance Program (CHIP) patients in the counties and geographical areas impacted by Hurricane Irma and Hurricane Harvey, or see patients who have been displaced from their homes in these areas who are in need of care, you need to know how government payers are responding t...
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Hurricane Harvey’s Public Health Crisis

Hurricane Harvey wreaked havoc in southeastern Texas last week. The tropical cyclone or what is called a category four hurricane caused unprecedented and catastrophic flooding in the southeastern part of the state. It was the first major hurricane in the U.S. since Wilma in 2005, a category five hurricane with winds of up to 185 mph.Harvey is the w...
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Tips to Make the Most of Your Community Health Needs Assessment

Non-profit hospitals must conduct a community health needs assessment (CHNA) every three years and submit a report detailing the CHNA's findings in order to comply with Section 501(r) of the Internal Revenue Service tax code and maintain their non-profit status. The following compendium of recommendations and reminders will help your organization d...
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CMS Modifies Bundled Payment Programs, Seeks Comments

The proposed rule change posted to the Federal Register on August 10, 2017 indicates the Centers for Medicare and Medicaid Services (CMS) will rescind the regulations governing two mandatory bundled payment programs, the Advancing Care Coordination through Episode Payment Models (EPMs) and Cardiac Rehabilitation Incentive (CRI) Payment Models, whic...
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CMS New Rule Aims to Boost Flexibility, Innovation

On August 2, 2017 the Centers for Medicare & Medicaid Services (CMS) issued the Fiscal Year (FY) 2018 Inpatient Prospective Payment System (IPPS) final rule that updates Medicare payment and polices when patients are discharged from hospitals. The changes, which will apply to approximately 3,330 acute care hospitals and approximately 420 long-t...
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Data Breach Website Helps Providers and Patients Research and Report

Among other things, the HITECH Act of 2009 requires the Department of Health and Human Services (HHS) to publish information about breaches of protected health information (PHI) involving 500 or more patients. Following recent changes to the agency's website, that information still appears, but if the breach is 24 months old or older, it now appear...
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Industry Groups Fuming about OPPS Proposed Rule Cuts of 340B Payments

The Centers for Medicare & Medicaid Services (CMS) is pursuing changes that would cut 340B payment rates to hospitals and may impair safety-net hospitals' ability to treat low-income patients.The 340B program requires drug manufacturers to provide outpatient drugs to eligible healthcare organizations and covered entities at considerably reduced...
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OIG Announces New Work Plan Process

The Department of Health and Human Services, Office of Inspector General (OIG) has announced that it is converting to a "dynamic, web-based Work Plan" format. Under this new policy effective June 15, 2017, Work Plan updates that have historically been released once or twice each year will now be released monthly in order to "enhance transparency ar...
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Six Cybersecurity Imperatives: National Task Force Maps a Cohesive Plan for Healthcare

Healthcare's uniquely and inherently open and sharing culture enables healthcare professionals and facilities to carry out their very important work. But this same openness, which includes an increasing number of disparate but connected health information systems, also makes healthcare uniquely vulnerable to myriad types of intrusions on the privac...
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25 Keys to a Patient-Centric Revenue Cycle

Optimizing your revenue cycle management process is a key component for addressing a multitude of industry trends such as changes in regulations, consumerism and new reimbursement structures.Today's patient centric revenue cycle requires the right systems to drive performance; however, employing systems based solely on their robustness does not gua...
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Medicare Reimbursement Policy Changes Under the 21st Century Cures Act

The 21st Century Cures Act (CCA) has been proclaimed by some policymakers to be "the most important legislation" Congress passed in 2016. Among many important provisions relating to precision medicine, drug innovation, telemedicine and mental health reform, the CCA also includes several potentially high-impact Medicare reimbursement policy changes ...
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