Friday, May 26, 2017

Budget Proposal for 2018 May Cut Support for Disability Social Security

The White House is in the final stages of readying the 2018 fiscal budget that seeks to resolve the economic deficits the government is currently facing. Central to its plan of achieving this goal is making drastic cuts to mean-titled entitlement programs, such as Temporary Assistance for Needy Families, Supplemental Security Income, child nutrition programs, the Pell Grant program and food stamps.

This development comes as a surprise, especially after President Trump had made it a focal point of his campaign that he will not be cutting into these programs. While reports indicate that the budget changes will primarily be focusing on means-tested programs, there is also word that the Social Security Disability Insurance program will also be affected by these changes.

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Thursday, May 25, 2017

Eligibility for Medicaid May Be Changed by the Proposed Replacement for Obamacare

Medicaid has played a big role in keeping millions of Americans adequately insured and protected with a viable health coverage. Specifically designed to make healthcare more accessible to low-income Americans, Medicaid implements a strict standard before an individual can be declared eligible for the benefits offered.

Many of the beneficiaries of Medicaid are elderly or disabled. The program’s existence is crucial to states delivering quality healthcare to their constituents. States and local governments must carefully balance their budgets to have adequate resources to allocate for this program.

Uncertain Future

Medicaid as well as the rest of the components of the Affordable Care Act (Obamacare) remains under threat of repeal and replacement. It had a very close call only recently, but the reprieve is short as another proposal has now been passed by the GOP.

Read more from this article: http://bit.ly/2rCePij

Wednesday, May 24, 2017

Challenges in Healthcare Revenue Cycle Management and How Hospitals Can Weather the Storm


Last year, local hospitals reported good records despite the challenges in revenue cycle management. Increasing operating costs, regulatory issues, flat reimbursements and the switch from patient volumes to lower-paying outpatient and observation services didn’t faze many healthcare providers. Thanks to a strong stock market and lower tax-exempt bond costs, hospitals continued to do well.

While this is good news, providers can’t be complacent now with the changes and regulations awaiting the Affordable Care Act. Under the Trump administration, the U.S. House Republicans recently gave the greenlight to a bill that would revise the 2009 Obamacare. It still needs to get the approval of the Senate, but many are concerned about the impact it will have if it’s passed.

Repealing the Expansion of Medicaid

One of the major concerns is Medicaid expansion. If the bill pushes through and removes that program, it will affect people who are enrolled in it, along with the revenue of their associated hospital. St. John Providence Health System in Warren, for example, has seven hospitals and 670,000 people enrolled in Medicaid. Non-profit hospitals like these will be the hardest hit when Medicaid expansion is repealed.

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Tuesday, May 23, 2017

The Digital Environment Revenue Cycle Management Companies Are Building

Major changes in revenue cycle management (RCM) technology are in store for health providers, including the small physician practice market. Currently, small medical practices are having a hard time handling the fast growth of patient payments, account management inefficiencies, and regulatory environment changes. These difficulties affect their collection of revenues, which can eventually derail the quality of services patients get when left ignored.

However, the use of electronic health records (EHR) is starting to change the landscape and improve the way healthcare organizations gather, analyze and report data. Experts believe that advanced RCM systems will keep on expanding as RCM providers work to incorporate new tools with unified platforms to enhance patient engagement, population health management and analytics. In fact, 97% of hospitals and nearly three quarters of providers are utilizing certified EHR technology.

EHR implementation poses challenges, as well, since the shift from paper to electronic records would demand a lot of time, energy and capital of a healthcare organization. These changes also call for additional training for staff involved in RCM and familiarize themselves with the ins and outs of the technology.

Read more from this article: http://bit.ly/2rBOocw

Monday, May 22, 2017

With Social Security in Trouble, One’s Eligibility for Social Security Disability May Become Unclear

There has been a number of discussions in Washington about the future of social security in the country. Some argue that it needs major reform. To compound matters, the sum of the President’s actions in recent months seem to imply that disability benefits and social security itself may soon be in danger.

Cost of Social Security Continues to Rise

The Social Security Disability Insurance program has continued to grow in costs over the past few years. In fact, reports estimate that it cost $143 billion back in 2015. As the costs continue to rise, officials are now saying that the disability part of the Social Security Trust Fund may well be completely exhausted by year 2022. Should this happen, benefits would automatically be cut for everyone.

In the past, lawmakers acted urgently to stabilize the disability fund. In fact, in 2015, they transferred funds from Social Security’s main trust fund to help fund disability. This time around, however, this kind of ‘fix’ may no longer work. That’s because the scenario has become more complicated than in previous years.

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Friday, May 19, 2017

Social Security Disability Eligibility Faces Investigation Due to A Slew of Fraud Cases

Recently, the Social Security Administration has reportedly taken some steps to both identify and assess various fraud risks when it comes to its disability programs. According to the U.S. Government Accountability Office (GAO), the administration had managed to gather information on fraud risks during the past year, but the method had not been systematic. Moreover, the significance, likelihood and impact of all the risks identified was also not assessed. With this, hospitals and healthcare providers need to anticipate possible changes in eligibility requirements.

Fraud in Disability Has Been Going On for Some Time

During the fiscal year 2015, the payments from both Social Security Income and Disability Insurance programs amounted to approximately $200 billion. Currently, the extent of fraud across both programs are unknown.

However, several high-profile cases have made it clear that a number of individuals have managed to obtain millions of dollars in benefits fraudulently. In fact, more than 70 individuals had pled guilty to participating in a social security disability eligibility conspiracy to obtain at least $14 million in fraudulent benefits back in 2014. This is exactly why the GAO was asked to review the Social Security Administration’s fraud risk management.

Read more from this article: http://bit.ly/2rOra04

Thursday, May 18, 2017

New Health Insurance Marketplace Coverage Options Get Thinner as Providers Exit ACA Marketplace

The continuing saga of the proposed changes with the Affordable Care Act is putting a lot of things in limbo, and a lot coverage providers are running for cover. Case in point, the latest company to back out of the marketplace is Aetna.

The insurer has two remaining states in their service list, namely Nebraska and Delaware, but it won’t be for long. The company has recently confirmed that they will no longer be entering back into the marketplace to sell individual health plans for the said states, a move which comes shortly after dropping Virginia from their 2018 service list.

Earlier in the year, the company had already declared that they will be letting go of Iowa. Originally, Aetna held as much as 15 states where they offered Obamacare policies. By mid-2016, however, they started to pull out from 11 of these. With the last two states now being dropped as well, it signals the official and complete exit of the insurance company from the ACA marketplace by 2018.

Read more from this article: http://bit.ly/2rfcF8u

Wednesday, May 17, 2017

Affordable Care Act Marketplace Changes May Leave Some States Without Insurers

Over the past couple of months, insurers have been jumping ship from the Obamacare marketplace that has been under attack even more aggressively in the past year. While the changes are to be expected following the change in the administration, what remains unclear is whether or not the people relying on their ACA coverage will continue to have insurance coverage.

Coverage Woes

As it stands, there are already a lot of problems concerning the viability of the Affordable Care Act Marketplace. In certain states like Iowa, a lot of insurers have already stepped out of the picture, while others are about to ease their way to the exit. What this means is that locals are going to be hard pressed to find an alternative, or a backup plan, to keep their coverage intact for as long as possible.

In the meantime, the lawmakers are still struggling to come up with a suitable replacement that will be approved not only by the House but also by the Senate. So far, the two houses appear to be badly out of sync with each other when it comes to health care.

Read more from this article: http://bit.ly/2rO9zFx

Monday, May 15, 2017

A Look at the Facts on Social Security Disability for Children and Privatization

Whether you believe in privatization of social security or not, the fact remains that it would cause significant changes within the revenue cycle management industry. The general public don’t hold out much hope when it comes to receiving benefits from the program. In fact, only 37% of those questioned believe somewhat that the social security system will benefit those in the future as much as it does today.

What does a privatized social security system look like, and how will this affect social security disability for children and countrywide revenue cycle management processes?

How is Social Security Being Privatized?

The general idea for a privatized social security system is that instead of paying taxes and ultimately receiving benefits in the future, people will make monetary contributions to their own privately managed savings accounts.

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Friday, May 12, 2017

Employ More Assistants to Improve Hospital Revenue Cycle Management Processes

Recent years have seen numerous changes headed towards hospital revenue cycle management processes, including the introduction of ICD-10 and changes to Medicaid and Obamacare. Because of this, healthcare facilities need to become more creative in how they manage these issues while still maintaining focus on keeping costs low.

Although it may initially seem counterproductive, the truth may be that increasing the amount of assistants employed across the hospital setting may be the answer to streamlining revenue cycle management processes.

Keep Billing Specialists Focused on Their Role

If your healthcare facility expects billing specialists to speak to patients about denied claims, outstanding balances and collect the copay, you may need to rethink this model. Instead of using the costly time of specialists for these matters, leave them to focus on completing coding on patient documents instead.

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Wednesday, May 10, 2017

The Advent of Online Billing Portals Spurs Revenue Cycle Management Services to Adjust

How familiar is your health care facility with the primitive payment options available to patients? If you only have a simple username and password system for a third party payment site, you’re already behind the times when it comes to new technologies that streamline revenue cycle management services.

Recent evidence reveals concerning trends in healthcare collections. Patients are now expected to assume more responsibility for the cost of their health care, which means hospitals are required to be much more upfront about the portion of the bill each person is expected to pay. While patient satisfaction may increase, many bills might go unpaid and healthcare facilities might begin to suffer if suitable processes aren’t in place to collect these payments.

Some Background on Online Payments

Due to concerns over patient confidentiality, online payment methods inherently involve complex or hardly simple procedures. A common method involves an online form completed by patients who convey their payment details on the form. The snarl in this method develops when a revenue cycle management worker must then re-enter these details to manually process the payment.

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Monday, May 8, 2017

What is Revenue Cycle Management Going to Look Like with Increased Consolidation?

Today’s news stream brims with discussions around the increased levels of consolidation in the U.S. healthcare industry. Meanwhile, many healthcare providers are now asking, “What is revenue cycle management going to look like with a rise in consolidation?”

To understand any coming changes, the recent trends in consolidation need to be examined carefully by providers and their revenue cycle management companies.

The Shift to Value Based Care

National healthcare expenditures continue to rise, currently at a level of 18%, compared to only 12.5% in 1990. The onus now rests on healthcare facilities to find a way to combat this rise. Generally, they are countering with significant consolidation of services.

Read more from this article: http://bit.ly/2reZbJF