New & Notable
Indirect billing by APCs common for office-based care
A study shows indirect billing by advanced practice clinicians (APCs) occurred for 39% of all office-based encounters with Medicare patients in 2022, highlighting the role of APCs.
Only a third of CMMI models yield substantial net savings
Most CMMI models did not generate significant savings to the federal government, if any savings at all, according to a recent analysis.
CMS proposes 2.4% inpatient Medicare reimbursement hike
The FY 2026 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) proposed rule would increase inpatient Medicare reimbursement by about $4 billion.
AHA pushes for inflation boost for physician reimbursement
AHA seeks a greater update to physician reimbursement compared to what MedPAC has recommended to lawmakers following reductions in Physician Fee Schedule payments.
Insights
Insights is research conducted by and for TechTarget Xtelligent Healthcare. Our work aims to leverage Xtelligent’s diverse readership of healthcare professionals across various sectors of the industry to understand real-world challenges and identify effective solutions.
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Sponsored Sites
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Healthcare
Huron
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Brault
Brault is a revenue cycle and practice management organization that partners with hospitals and independent physician groups. Their intelligent practice solutions include coding and billing, MIPS optimization, provider documentation training, and practice management.
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Greenway Health
Improving healthcare through innovation is at the heart of Greenway Health’s work. We provide electronic health records (EHR), practice management, and revenue cycle management solutions that help practices in multiple specialties grow profitably, remain compliant, work more efficiently, and improve patient outcomes.
Healthcare Strategies: A Podcast
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A podcast for healthcare professionals seeking solutions to today's and tomorrow's top challenges. Hosted by the editors of Xtelligent Healthcare Media, this podcast series focuses on real-world use cases that are leading to tangible improvements in care quality, outcomes, and cost.
Guests from leading provider, payer, government, and other organizations share their approaches to transforming healthcare in a meaningful and lasting way.
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Latest News
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Lagging reimbursement rates threaten U.S. emergency care
Hospital-based emergency care is under threat as reimbursement rates continue to fall while uncompensated and undercompensated care increases, according to a new RAND report.
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Senate confirms Oz as CMS administrator
In a party-line vote, the Senate confirmed Mehmet Oz, M.D., to lead the Centers for Medicare and Medicaid Services.
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AHA seeks to address barriers to value-based care adoption
The American Hospital Association identified value-based care adoption barriers, such as revenue thresholds and limited incentives, and advised policymakers on how to address them.
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Medicare Advantage enrollment slows, increasing 3.9%
Strong market headwinds dampened Medicare Advantage enrollment during the 2024 annual enrollment period but growth in MA and SNP plans remains strong in 2025.
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Providers don't see better quality under value-based payments
Primary care providers do not see the benefits of value-based payments on quality of care at the organizational level as many report increased workloads and moral distress.
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Value-based care leaders share tips for greater progress
Two experts in value-based care provide tips for accelerating the shift away from fee-for-service, such as bolstering primary care and adjusting models that penalize success.
Features
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5 leading hospital chargemaster software products
Hospital chargemaster software from FinThrive, Health Catalyst, Optum and other vendors can streamline CDM maintenance while using analytics to inform market strategy.
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Common denial reason codes in medical billing
Claim denial reason codes in medical billing indicate problems in the revenue cycle, understanding the codes and identifying patterns is key to prevention.
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RPA to Gen AI: How AI in revenue cycle management is evolving
AI in revenue cycle management is at an inflection point, with providers adopting automation, NLP and generative AI to streamline processes and reduce burdens.
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How healthcare consumerism is driving provider revenue growth
Learn how providers are aligning more with healthcare consumerism to grow revenue and services and using technology to promote consumer affordability and convenience.