Medicare Advantage patients account for fewer avoidable hospitalizations. Here's why
Fierce Healthcare
FEBRUARY 27, 2023
Medicare Advantage patients account for fewer avoidable hospitalizations. Here's why rking Mon, 02/27/2023 - 17:41
Accountability Related Topics 
Kaufman Hall: Performance stable, but high labor costs challenge hospitals
Fierce Healthcare
NOVEMBER 15, 2024
Labor expenses from providers accounted for 84% of medical groups’ total expenses. Though hospital performance has remained relatively stable, high labor costs continue to challenge hospitals’ bottom line, according to September figures from Kaufman Hall.
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Compassus CEO: To ‘Grow Up,’ Home Health Industry Needs To Become Accountable
Home Health Care
NOVEMBER 27, 2024
In a lot of cases, the home-based care isn’t accountable. It doesn’t mean that we don’t care deeply about the outcomes for patients, just that the industry hasn’t matured to have accountable relationships. Certainly, there’s accountability to CMS for quality and those sorts of things.
Hospitals have low level of accountability for connected device breaches
Health Care Dive
AUGUST 4, 2022
Of the 43% of organizations that reported a data breach in the past two years, 88% said at least one connected device was a contributing factor to the breach, according to a new report.
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Hospitals make major gains on handwashing compliance, accountability, Leapfrog finds
Fierce Healthcare
SEPTEMBER 17, 2024
Handwashing adherence is on the up-and-up as more hospitals are holding their leadership accountable for hand hygiene, patient safety watchdog The Leapfrog Group reports. |
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CMS holds accountable care organizations harmless for ‘highly suspect’ Medicare billing
Health Care Dive
SEPTEMBER 25, 2024
Aberrant billing for urinary catheters last year could have made it harder for ACOs in Medicare to bring in shared savings. That’s no longer the case under a new final rule.
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Out-of-pocket spending on prescriptions grew even after accounting for rebates: study
Fierce Healthcare
SEPTEMBER 3, 2024
There's no shortage of attention on rising pharmaceutical costs, but policymakers need to have the full picture of trends in this space to work off of, according to a new study.
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Medicare saves record $2.1 billion from largest accountable care program
Health Care Dive
OCTOBER 31, 2024
Citrus ACO in Central West Florida had the highest savings rate, while Health Connect Partners — an ACO operated by hospital giant Providence — had the highest total savings in the Medicare Shared Savings Program last year.
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12 Comprehensive Tips to Improve Your Accounts Receivable Collection
Etactics
JANUARY 24, 2025
Thats why accounts receivable (AR) is such a vital process to boost within your revenue cycle management (RCM) system. Lack of accounts receivable management can easily derail your RCM process and ability to stay financially healthy. So today, we are going over 12 tips on how to improve your accounts receivable management processes.
Even modest meds adherence can be financially transformative for health systems
Healthcare It News
JANUARY 23, 2025
As healthcare continues to advance with accountable care organizations and value-based care models, the industry is starting to see some real traction after a decade of groundwork in the form of CMS claims for the Medicare Shared Savings Program. There are some critical elements driving success here.
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$2M e-ICU project to be launched in regional Korea
Healthcare It News
DECEMBER 22, 2024
Another study also noted regional disparities in the number of ICU beds and length of stay from 2011 to 2019: two regions, Seoul and Gyeonggi-do, accounted for almost half of the country's total ICU beds and length of stay, which suggested centralisation of the health system, according to researchers.
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Healthcare must become as digital and consumer friendly as retail and banking
Healthcare It News
OCTOBER 12, 2024
Because of this, providers have a hard time giving estimates, so patients often are forced to make decisions about their care without knowing how it will impact their bank account. Every business should prefer getting paid faster and have funds deposited directly into your bank account without additional manual intervention.
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PBMs defend business practices — but lawmakers aren’t convinced
Fierce Healthcare
JULY 23, 2024
Lawmakers bashed the business practices of pharmacy benefit managers during a House Committee on Oversight and Accountability hearing Tuesday. | A contentious hearing between PBM CEOs and the House Commitee on Oversight and Accountability reinforced recent federal angst toward pharmacy benefit managers, but little new ground was made.
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MSSP ACOs saves Medicare $2.1 billion in 2023, the largest savings in program history
Fierce Healthcare
OCTOBER 29, 2024
Accountable care organizations saved Medicare $2.1 Accountable care organizations (ACOs) saved Medicare $2.1 billion, the largest yearly savings in program history, in 2023, the Centers for Medicare & Medicaid Services revealed on Tuesday.
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An Overview of Insurance Billing Services for Healthcare Providers
p3care
DECEMBER 18, 2024
Payment Posting In this step, the received payments from the insurance companies and patients are applied to the relevant accounts. It also involves addressing the claim denials, rejections, and requests to provide additional information on time to protect the practice from losing well-deserved revenue.
HHS facing challenges as lead agency for healthcare cybersecurity: GAO
Health Care Dive
NOVEMBER 19, 2024
The department hasn’t implemented some policies recommended by the watchdog, which could pose a risk to cybersecurity in the sector as attacks increase, according to the Government Accountability Office.
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An Overview of Medical Billing and Coding Services
p3care
NOVEMBER 1, 2024
Improved Revenue It will reduce your days in accounts receivable management (AR) by reducing the claim denials ratio and boosting revenue. Fast Submissions With an advanced medical billing and coding system, quick submissions of medical claims will be ensured for timely reimbursements and increased cash flow.
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Amazon’s PillPack reports data breach affecting more than 19,000
Health Care Dive
MAY 22, 2023
Around 3,600 affected accounts included prescription information. The online pharmacy said the attack exposed customers’ email addresses, prescription information and contact details for their prescribing provider.
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Mount Sinai team creates AI algorithm to detect sleep disorder
Healthcare It News
MARCH 17, 2025
"Notably, although a video camera records any movements during sleep, the current standard for interpreting the test does not take any of that into account, and no automated tool currently exists for interpreting video data," During noted.
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ACOs led by independent physicians save Medicare ‘substantially’ more money, CBO says
Health Care Dive
APRIL 17, 2024
Independent practices have clearer financial incentives to lower medical spending than hospitals participating in accountable care organizations, according to the Congressional Budget Office.
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Primary care market will see major shifts by 2030 as payers, nontraditional providers gain ground
Fierce Healthcare
DECEMBER 5, 2024
Two years ago, Bain and Company forecasted ma | Nontraditional providers will account for about one-third of the primary care market in 2030, according to Bain and Company. Payer-owned primary care, population-focused models and advanced primary care providers are all poised for growth.
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Atrium Health responds to new social engineering attack
Healthcare It News
SEPTEMBER 17, 2024
WHY IT MATTERS Part of Advocate Health, the third-largest nonprofit health system in the United States, Atrium recently learned that an unauthorized third party accessed a limited number of employee email accounts through the original phish sent on April 29. Bank or financial account numbers or information. Medical record number.
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How virtual-first can improve outcomes and make care more affordable
Healthcare It News
NOVEMBER 12, 2024
This model works sometimes; but it cannot account for people who have multiple, interconnected conditions, like diabetes and high blood pressure. This proactive care helps patients stay ahead of their medical conditions, reducing the likelihood of hospitalizations and expensive surgeries.
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EMR implementation as a 'science'
Healthcare It News
OCTOBER 10, 2024
" He said the time a pharmacist spends following up with doctors about their prescriptions should also be accounted for. For Dr Appannan, it depends on the type of case. "Complex cases require more time."
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False claims settlements in healthcare total $1.7B in 2024
Health Care Dive
JANUARY 17, 2025
Healthcare fraud investigations accounted for more than half of the Department of Justice’s settlements and judgments in 2024, which totaled north of $2.9
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Healthcare was most breached sector in 2024: report
Health Care Dive
FEBRUARY 19, 2025
Last year, the healthcare industry accounted for 23% of data breaches handled by financial and risk advisory firm Kroll, compared with 18% in 2023.
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HealthEquity data breach could affect 4.3M
Health Care Dive
JULY 30, 2024
The health benefits administrator said a vendor’s user accounts were compromised, and information like contact details, Social Security numbers and medical information could be exposed.
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Cigna posts $739M in Q3 profit despite taking a $1B hit from VillageMD investment
Fierce Healthcare
OCTOBER 31, 2024
The Cigna Group reported $739 million in profit for the third quarter, a figure that accounts for a $1 billion after-tax investment loss tied to VillageMD. | The Cigna Group reported $739 million in profit for the third quarter, a figure that accounts for a $1 billion after-tax investment loss tied to VillageMD.
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Digital Transformation 101: A handy primer
Healthcare It News
MARCH 21, 2025
If the aim is a strategic, enterprise, long-term reimagination of the business, it must be led from the top of the organization: The CEO should be responsible and accountable to create a compelling, clear vision for the direction and collaborate with their leadership team to gain support for the new direction across the entire organization.
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Healthcare worker exodus continued through 2022, new data shows
Health Care Dive
OCTOBER 17, 2023
Physicians accounted for nearly half of departures from 2021 through 2022, with staffing shortages putting care quality at risk, according to a new report from Definitive Healthcare.
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Standards, audits and $1.3B: How Wyden and Warner propose to improve healthcare cybersecurity
Fierce Healthcare
SEPTEMBER 26, 2024
Ron Wyden, Oregon, and Mark Warner, Virginia, introduced the Healthcare Information Security and Accountability Act on Thursday to beef up cybersecurity for hospitals. Democratic Sens. Democratic Sens.
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Cigna writes down VillageMD investment amid shrinking value
Health Care Dive
MAY 2, 2024
Walgreens’ decision to slash VillageMD’s clinical footprint has reverberated to the financial accounts of the primary care chain’s minority owner — Cigna.
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CMS proposed payment rule includes major updates for ACOs
Health Care Dive
JULY 8, 2022
Changes to the Medicare Shared Savings Program would give some accountable care organizations more time to ramp up to performance-based risk and updated quality reporting.
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COVID-19 fell from top telehealth diagnoses in September
Health Care Dive
DECEMBER 8, 2022
Telehealth use has remained steady this year and did not change nationally from August to September, accounting for 5.4% of all medical claims, according to Fair Health.
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Third-party data breach round-up: mscripts, Diligent, Mailchimp
Healthcare It News
JANUARY 30, 2023
The email marketing service provider temporarily suspended those accounts to protect user data. Mailchimp was first breached in April 2022, and threat actors were able to view around 300 user accounts and obtain audience data from 102 of them, as reported by the chief information security officer to the HHS cybersecurity program.
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Government watchdog warns of Medicare fraud after relaxing provider requirements
Health Care Dive
DECEMBER 20, 2022
The Government Accountability Office is urging the CMS to resume certain eligibility checks on providers whom they consider at high risk of fraud to the Medicare program.
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HSA administrator HealthEquity discloses data breach impacting 4.3M
Fierce Healthcare
JULY 29, 2024
HealthEquity, a prominent health savings account administrator, has disclosed a data breach it says impacted 4.3 million people. | The company filed a notice with Maine's attorney general and revealed that it received an alert on March 25 about a potential security incident, and then proceeded to conduct an investigation.
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Fighting maternal and infant health inequities
Fierce Healthcare
JULY 16, 2024
In this week’s episode of “Podnosis,” Fierce Healthcare’s Anastassia Gliadkovskaya explores the topic of inequities in maternal and infant health and what one nonprofit is doing to increase transpa | In this week’s episode of “Podnosis,” Fierce Healthcare’s Anastassia Gliadkovskaya explores the topic of inequities in maternal and infant health and (..)
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Government watchdog warns of Medicaid oversight gaps
Health Care Dive
MARCH 18, 2024
The CMS doesn’t require states to report data on outcomes or care denials, and has made “delayed” progress on plans to analyze the information and make it public, according to the Government Accountability Office.
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Federal agencies open online portal for reporting anticompetitive practices in healthcare
Fierce Healthcare
APRIL 18, 2024
FTC, DOJ and HHS said that information and accounts received from the public could plant the seeds for formal investigations into healthcare companies' monopolistic or anticompetitive practices. Federal agencies want to hear from the public about monopolistic and anticompetitive behavior within the healthcare industry. |
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Payers' increasing claims denials, delays 'wreaking havoc' on provider revenue cycles
Fierce Healthcare
DECEMBER 13, 2023
A jump in claim delays and denials is “wreaking havoc on providers’ revenue cycle performance” and contributing to health systems’ “volatile” accounts receivable and diminishing cash reserves, acco | More frequent pushback from commercial and Medicare Advantage payers is complicating patient self-pay collections and, ultimately, undermining the revenues (..)
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Stanford uses AI to navigate health information sharing with teens and their families
Healthcare It News
JANUARY 30, 2024
" Second, a natural language algorithm was created to monitor messages within teen patient portal accounts. The system was designed to detect any inappropriate use of the account by the guardian, such as attempts to access sensitive information. The advent of large language models has opened up a world of possibilities.
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CMS officials say agency is monitoring concerns from ACOs about DME costs
Fierce Healthcare
APRIL 11, 2024
Accountable care organizations have sounded the alarm on billions in durable medical equipment fraud, and officials at the Centers for Medicare & Medicaid Services (CMS) said Thursday that the | Accountable care organizations have sounded the alarm on billions in durable medical equipment fraud, and officials at the Centers for Medicare & Medicaid (..)
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Cerebral says 3M affected by a patient data breach
Healthcare It News
MARCH 13, 2023
If an individual did more than create an account – such as take the online assessment – "the information disclosed may also have included the service the individual selected, assessment responses and certain associated health information," Cerebral added.
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