CMS has released its Hospital Inpatient Prospective Payment System (IPPS) proposed rule for fiscal year 2023, which includes a payment rate boost for general acute care hospitals and new measures focused on health equity for the Hospital Inpatient Quality Reporting (IQR) program.

As we know, with the growth of outpatient surgical centers, advances in medical technology, and the shift of payers’ understanding in what they will consider to be an inpatient episode of care have all impacted the hospital patient composition.

The average cost of debunking a denial is $25 per claim, not to mention the continuous challenges associated with attaining timely payment. Reviewing denial management strategies on a regular basis may prove a more efficient payment journey.

Providers are bracing for the end of government funds to administer COVID-19 vaccines. Starting Tuesday, April 5, the Department of Health and Human Services will no longer adjudicate claims submitted for vaccine administration due to a lack of funds, according to the Health Resources & Services Administration.

The Accountable Care Organization (ACO) Realizing Equity, Access, and Community Health (REACH) initiative is a new model for ACOs operating under Medicare. It will be tested under the Centers for Medicare & Medicaid Services (CMS) Innovation Center’s authority and will adhere to the following priorities: a greater focus on health equity and closing disparities in care; an emphasis on provider-led organizations and...