Spending growth in the $2.9 trillion US health economy is expected to slow in 2016 as compared to 2015; however, it will still outpace overall economic inflation. Stock prices, earnings reports and the customer base have increased and that means the industry is financially healthy. Sadly, affordable healthcare remains out-of-reach for many consumers.
PwC’s Health Research Institute (HRI) projects the U.S. healthcare spending growth rate will dip to 6.5 percent in 2016, capping a
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Healthcare Policy Regulation & Reform | News, Analysis, Insights - HIT Consultant
New Bill Proposes 2 Year ICD-10 Grace Period
A new bill introduced into the US House of Representatives introduced by Rep. Gary Palmer (R-AL-6) on June 4 proposes a two-year “grace period” for accepting codes submitted in ICD-10-CM/PCS. The bill, H.R. 2652, Protecting Patients and Physicians Against Coding Act of 2015, would establish a two-year ICD-10 grace period during which physicians and other health care providers submitting claims and other documents using ICD–10 are not penalized for errors, mistakes, and malfunctions relating to
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CMS Releases April ICD-10 End to End Testing Results
CMS has announced the results of its second ICD-10 end to end testing week conducted from April 27 through May 1, 2015 for Medicare Fee-For-Service (FFS) health care providers, clearinghouses, and billing agencies. CMS was able to accommodate most volunteers, representing a broad cross-section of provider, claim, and submitter types. Approximately 875 providers and billing companies participated, and testers submitted over 23,000 test claims.
Key results include:
• The acceptance rate
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5 Common Myths About The ICD-10 Transition
With ICD-10 compliance date less than five months away, there is still an abundance of common misconceptions associated to this transition. For providers, these ICD-10 misconceptions can prove extremely costly and damaging to the implementation.
Pam Klugman, chief product officer of Clear Vision Information Systems specifically warns providers to avoid these five common myths about ICD-10:
1. The new ICD-10 codes are simply increased and renumbered code sets. While it is true
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5 Cultural Pitfalls To Avoid In Health System Integration
Editor's Note: This spotlight article was recently included in PwC's Q1 2015 US health services deals insights report.
These days it seems every health system is in the middle of a transformation — be it buying, selling or trying to integrate the assets it has amassed over time. Being in the business of transformation, this means we find ourselves invariably and repeatedly answering the question, "What are the big stumbling blocks to avoid?"
Without fail, our answer will include some
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Parity Not Apparent: There Is No Biopsy for Mental Illness
Getting legislation through Congress—often a monumental battle—is one thing. But implementing new laws may be a greater challenge simply because they require so much sustained energy and attention.
Take mental health parity laws, for example.
Congress passed the Mental Health Parity Act (MHPA) championed by Sens. Paul Wellstone (D-MN) and Pete Domenici (R-NM) in 1996. The law prohibits employee-sponsored group health plans from charging more in a year or over a lifetime for mental health
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The Death of Fee-for-Service in Healthcare
On April 16, 2015, President Obama signed into law H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015(MACRA), effectively sentencing Fee-for-Service (FFS) to death. The best explanation for how FFS is destroying the nation comes from Charles Munger, vice-chairman of Berkshire Hathaway and ad-hoc health luminary, who is equating what American doctors do, to raising rattlesnakes so they can collect the bounty for dead rattlers offered by the government in an effort to combat a
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4 Strategies to Building A Modern Healthcare Billing & Payment System
The U.S. healthcare industry’s billing and payment system is a horse-and-buggy in a world contemplating driverless cars. Consumers, shouldering higher costs, are frustrated by the system, which still largely relies on paper and telephone calls for billing and payment. The $2.9 trillion sector needs to transform the way it does business, creating a more transparent, seamless, convenient way to bill and collect money from its customers, according to “Money matters: Billing and payment for a New
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HHS Announces $101M in ACA Funding to 164 Community Health Centers
HHS Secretary Sylvia M. Burwell announced today approximately $101 million in Affordable Care Act funding to 164 new health center sites across 33 states and two U.S. Territories for the delivery of comprehensive primary health care services in communities that need them most. These new health centers are projected to increase access to health care services for nearly 650,000 patients.
Investment Details
This investment announced today will add to the more than 550 new health center sites
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12 Things You Need to Know About Value-Based Reimbursement
Public and private payers, including Medicare and some of the nation’s biggest health insurers, plan to hasten the migration of the healthcare reimbursement system from pay-for-volume to pay-for-value. The acceleration in the pace of change from fee for service to risk-based reimbursement is likely to reshape the healthcare business over the next three to five years.
While all healthcare stakeholders will be affected, the pioneers of this approach to healthcare financing will be large,
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