Study Forecasts Primary and Specialty Physician Shortages

It's no secret that the United States population is aging. In just over a decade, the number of Americans in the 65-and-older age bracket will have mushroomed by 50 percent. Not as widely known is the fact that this aging population is likely to impact physician supply as well, because one-third of all currently practicing physicians will be older ...
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Will Population Value Data Destroy the Healthcare Industry

Howard A. Green, MDDermatology Associates, PA, Palm Beach, FLThere's nothing new about 'population health.' Physicians practicing medicine (notice I didn't say practitioners practicing healthcare) have utilized population health studies or 'clinical studies' for the better part of two centuries. Physicians practicing medicine with patients observed...
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Senate and House to Review Opioid Bills

Committees of the House and Senate have introduced a wave of legislation to address the opioid crisis, including more than 30 bills related to Medicare and Medicaid coverage and payment. Highlights of the Opioid Crisis Response Act of 2018, introduced by the Senate Health, Education, Labor and Pensions Committee, include enhancing state prescriptio...
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RAC Changes on the Horizon

The controversial Recovery Audit Program of the Centers for Medicare and Medicaid Services had garnered criticism from the American Hospital Association and other groups for its role in generating a huge backlog of appeals that can take months, if not years, to resolve, straining hospitals' financial resources in the process. A 2017 study published...
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Lawmakers Renew Call for Healthcare Price Transparency; Stakeholders Comment

The federal government has turned the spotlight once again on the issue of price transparency in healthcare, with a bipartisan group of senators reaching out to a large swath of stakeholders for input and Secretary of Health and Human Services Alex M. Azar II naming it as a pillar of an agenda to increase value and lower costs for consumers. The ke...
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CMS Official Outlines Plans to Simplify MACRA

Some significant regulatory changes could be coming this year to the Quality Payment Program (QPP) of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) as part of an effort to lighten clinicians' administrative and quality reporting workloads. The update comes from Kate Goodrich, MD, chief medical officer of the Centers for Medicare ...
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HIMSS 2018: News and Trends from HIT’s Big Meeting

Developments in artificial intelligence (AI), precision medicine, cybersecurity and patient engagement were among the highlights of this year's conference of the Chicago-based nonprofit Health Information Management Systems Society (HIMSS). The meeting brought together more than 40,000 health information technology professionals from 50 countries t...
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Will Net Neutrality Repeal Help or Hurt Healthcare Providers?

The Federal Communications Commission (FCC) published its order on February 22, 2018 to repeal net neutrality, a set of regulations grounded in the premise that internet service providers should treat all web traffic equally as it passes through their networks. The order's publication follows a vote by the FCC in December to rescind the net neutral...
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A Refresher: The Quality Payment Program Revisited

The Quality Payment Program (QPP) is designed to improve Medicare outcomes by helping focus on care quality and making patients healthier. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the Sustainable Growth Rate formula, which has created a rift between physicians and the government. This payment model had severe financial...
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Drug Shortages Persist: An Update for Hospitals and Health Systems

Drug shortages can lead to a variety of complex adjustments in medical treatment that have the potential to jeopardize patient safety and interfere with the quality of care. And they remain a serious public health problem. A 2016 study by the Government Accountability Office (GAO) showed that, while the number of new drug shortages has trended down...
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What are Comparative Billing Reports and Why Should Medical Groups Care?

They might seem innocuous and inconsequential in a medical group's vast sea of paperwork and electronic data, but comparative billing reports (CBRs), administered by the Centers for Medicare and Medicaid Services (CMS) and prepared by a data mining company called eGlobalTech (eGT), are not something to ignore. Medical practices need to know what CB...
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Healthcare Ransomware Attacks Still Rising: What Providers Can Do

The massive transfer of health information during the past decade to online, internet-accessible systems has created a perfect storm of circumstances for the proliferation of cybercrime in the healthcare sector, including an 89 percent increase in reported healthcare ransomware attacks during the past year, a recently published report reveals.Among...
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3.2 Million More Americans Became Uninsured in 2017

The number of uninsured people in the U.S. has been a key topic of health policy discussions for decades and received increased scrutiny with the passage of the Affordable Care Act (ACA) in 2010 and the implementation of its insurance coverage expansions in 2014.The ACA led to celebrated gains in health insurance coverage. It expanded employer-base...
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ONC Releases Draft ‘Trusted Framework’ for Health Information Exchange, Seeks Comments

One of the hallmarks of the 21st Century Cures Act signed into law in 2016 was the creation of a "trusted exchange framework" to support the safe and interoperable exchange of electronic health information among providers and between providers and their patients. The Cures Act charges the Health and Human Services Office of the National Coordinator...
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Specialty Group Works to Boost Physician Well-Being and Satisfaction

A Health Affairs blog article co-authored this past year by 10 prominent health system CEOs describes the problem of physician burnout as a national public health crisis and "a matter of absolute urgency." The numbers support their contention. The Medscape Lifestyle Survey 2017 reveals that 51 percent of physicians report experiencing this energy-d...
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SOC 2 Type II Certification: A Security Imperative for Healthcare BPO Organizations

Last month, MiraMed Global Services received Statement on Standards for Attestation Engagements (SSAE) No. 16 Service Organization Control (SOC) 2 Type II Certification. The certification criteria reviewed and tested the following areas of MiraMed's policies and practices: Infrastructure: The physical and hardware components of a system. Software:...
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A Year of Uncertainty in Healthcare—and a More Resilient 2018

We close the year with a glance back at some of the most significant healthcare developments of 2017. The word of the year in health law and bioethics was "uncertainty," Carmel Schacar and I. Glenn Cohen of Harvard Law School proclaimed on Health Affairs' blog. The same might well be said of the healthcare sector as a whole. The current climate of ...
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Solid Revenue Integrity Strategies Offer Robust ROI

If you are familiar with how the healthcare revenue cycle operates, you should have heard the term "revenue integrity." It's become an industry axiom and many provider organizations understand the value of having a focus on revenue integrity services. Revenue Integrity DefinedIn healthcare, revenue can be defined as the reimbursement made by an ins...
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Tax Bill Healthcare Provision Portends Major Changes

It has been called "a behemoth piece of legislation that could widen American economic inequality while diminishing the power of local communities to marshal relief for vulnerable people." But it has also been hailed as "a comprehensive overhaul . . . [that] will ignite our economy with levels of growth not seen in generations," creating "more jobs...
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Reduce Reimbursement Leakage Through Revenue Capture Audits

In today's healthcare environment, capturing every cent of revenue due to a hospital, health system or physician group is a challenge. With the advent of legislative reform and changes in the systemic healthcare reimbursement structure, such as the evolving Accountable Care Organization model or value-based healthcare strategies, healthcare provide...
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