Claims Processing

It's often said that our society is one steeped in impatience. We want fast Internet, quick news, overnight deliveries. This culture of instant gratification even pervades healthcare, as can be seen in the outcomes of CMS' Pioneer ACO model, which initially boasted 32 member organizations but recently saw nine jump ship -- with two groups washing their hands of the project altogether.

In a recent federal court decision that went quietly under the radar but further opened the door for healthcare cost transparency, a U.S. district judge ruled to vacate a 33-year-old injunction that prevented the release of Medicare claims data.

Jonathan Bush, CEO of athenahealth, treated the audience to an energetic keynote at Healthcare Datapalooza IV, offering up a great deal of humor and perspective on the state of data exchange, policy and the healthcare system at large.

Tenet Healthcare's $4.3 billion acquisition of Vanguard Health Systems is likely to bring more business athenahealth's way, Piper Jaffray analyst Sean Wieland concluded in a note he issued June 24, even as he offered up other possible scenarios, such as a MED3000 business win, or a boon for Cerner.

You'd be forgiven for thinking revenue cycle management technology is a bit, well, boring. You'd also be wrong. The coming years are going to see some big changes in the way hospitals get paid -- and the IT they use to track when and how they get paid is going to have to change as well.

If there was an overarching theme at the HIMSS Media/Healthcare IT News ICD-10 Forum on June 17, it was this: Don't wait to get your house in order for ICD-10. Though the Oct. 1, 2014 deadline for the transition from ICD-9 to ICD-10 is more than a year away, most of that time will be required for getting ready, experts warn.

The Fourth Annual Health Datapalooza stayed true to its name. It was, indeed, all about data -- how to liberate data, the need to liberate data, structuring data, promising new data apps, and how data scientists just might have the sexiest career of the 21st century.

Marilyn Tavenner, acting administrator of the Centers for Medicare & Medicaid Services, received accolades from both sides of the aisle at a hearing on Tuesday to consider her nomination as head of CMS. Senate Finance Committee leaders indicated a decision would come soon.

Since 2007, and in the wake of the Great Recession, an additional 10 million Americans have enrolled in Medicaid, at the same time that states' tax revenue declined. But those long-plagued by Medicaid debt are starting to address their problems, several states are forging ahead with accountable care innovations and the consumer experience is becoming an increasingly important point of focus as states begin to modernize their systems.

Deborah Essex of Aspen Valley Hospital explains how incentives led to increased patient collections for the Colorado-based facility.