Is patient bad debt hurting your bottom line?

Healthcare providers are increasingly finding themselves acting as banks and bill collectors when it comes to getting paid for care. With the rise of high-deductible health plans and other cost-sharing, many patients are struggling to pay what their plans don’t cover. All too often, collection becomes the problem of clinical practices and hospitals. But there are ways to manage patient bad debt and prevent write-offs. Read more

Looking into the unknown: a 2017 healthcare preview

With a major changeover in political leadership effective January 2017, a cloud of uncertainty hangs over the fate of healthcare, which represents a third of the United States economy. Undoubtedly, significant changes are on the horizon, affecting everyone from the consumer to the provider to the payer. It’s not surprising there is much angst regarding the unknown. Read more

Mental Health Reform 2017

President signs landmark mental health reform

As part of the 21st Century Cures Act, mental health reform has become law with the president’s signature in December 2016. It’s the most significant mental health reform in more than 50 years and is part of a $6.3-billion package that addresses other high-priority medical issues and the cancer “moonshot” campaign to find cancer cures. Read more

Avoid patient coverage surprises after Open Enrollment

Open enrollment can create uncertainty and costly oversights for every healthcare provider. Premiums have already increased for the 2017 enrollment period, although major changes to the Affordable Care Act may take time to materialize. More immediate proposals for payment increases for skilled nursing facilities means the time to be aware of your options is right now. If you fail to detect a change in a patient’s coverage, the consequences can be severe, including delayed or even denied payments. When a patient changes health insurance and the new health plan denies reimbursement, you face an unpleasant choice: surprise the patient with a bill, or write off your services, costing you money. Read more

What’s to become of the Affordable Care Act (ACA)?

With the recent election spurring a “repeal and replace” mantra for the Affordable Care Act, opinions and speculation now circle around how likely, desirable or even possible that may be. There’s simply no telling what’s going to happen, especially with key cabinet positions and transition plans for the new administration still in flux. Even among those opposing the ACA, there are significant differences of opinion. Read more

ABILITY Partner Community

Questions about ACA’s future don’t change current open enrollment needs

While the outcome of the presidential election has thrown the future of the Affordable Care Act into question, early predictions are that if replacement legislation is enacted, it won’t go into effect until two years from now. The upshot is that the annual process of open enrollment will continue for the time being on and state exchanges, just as it will for Medicare and employer-sponsored plans. Read more

NAHC notes: what’s happening in home health?

ABILITY was well-represented at the National Association for Home Care & Hospice (NAHC) annual conference in Orlando in late October. ABILITY senior director of product management, Christine Lang, MBA, returned from the event with these observations. Read more

SNF eligibility

New health insurance eligibility game plans needed for 2017

As the days left in 2016 start to dwindle, medical providers would be wise to start thinking about the usual churn of patients in new insurance coverage that comes every January. The time to plan is now. Although plan membership can change at any time during the year, it is the first of the year that most often reshuffles the deck. Read more

Proposed CMS codes and fees align with realities for physicians

The Centers for Medicare & Medicaid Services (CMS) are bowing to the reality of all that primary care practices are asked to do these days. CMS is proposing a Medicare 2017 Physician Fee Schedule that recognizes the added complexity of these demands and the expanding role of the family physician. Read more

Accountable Care Organizations

Savings from Accountable Care Organizations continue adding up

As Medicare continues its push toward directing 50 percent of reimbursements through alternative payment models (APMs) by 2018, recently released data shows the mounting savings generated by Accountable Care Organizations (ACOs). Last year, ACOs achieved savings of $466 million, according to a report issued by CMS. Read more