The pMD Blog

Welcome to the
pMD Blog...

where we cover interesting and relevant news, insights, events, and more related to the health care industry and pMD. Most importantly, this blog is a fun, engaging way to learn about developments in an ever-changing field that is heavily influenced by technology.

POSTS BY TAG | Health Care


Here's The Latest in Health Care:


It was another tumultuous year for the revenue cycle, from the slow burn of price transparency and the fight over surprise billing, to the renewed focus on the workforce, not to mention the continuing COVID-19 pandemic. These are three issues that defined 2021 for the revenue cycle.   Read More

With the goal of offering a unified method for representing mailing, physical, billing and other addresses, to help improve patient matching, the Office of the National Coordinator for Health IT released the Project US@ (pronounced "Project USA") Technical Specification Final Version 1.0. The new specification was developed as a unified, cross-standard approach that can be implemented across healthcare organizations of all shapes and sizes.  Read More

Hospital mergers and acquisitions were down in 2021 as industry leaders faced another year battling the COVID-19 pandemic, new research from Kaufman Hall shows. While the number of hospital mergers and acquisitions remained low, the size of those few announced transactions was significantly up, researchers reported. But while the number of hospital mergers and acquisitions remained low, the size of those few announced transactions was significantly larger.  Read More

As the pandemic made scheduling medical appointments harder and continued to strain an overburdened healthcare system, some patients are turning to do-it-yourself care at home. Patients are increasingly turning to home testing kits, gadgets and health monitoring apps to manage their health, track their blood sugar and cholesterol levels and even conduct electrocardiograms.  Read More

Every other Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, medical billing revenue cycle management, telehealthsecure messaging, clinical communication, and care navigation software.

Here's The Latest in Health Care:


Hospitals and other corporate entities now own about half of all U.S. physician practices. However, the acquisition of independent physician practices by hospitals, a trend that has accelerated rapidly in recent years, is actually linked to a modest drop in doctor compensation according to a recent report. These findings contrast with evidence that hospital systems' profits tend to increase as prices and spending rise after the integration of physician practices.  Read More

Roughly 40% of U.S. healthcare payments were tied to alternative payment models (APMs) last year, with Medicare Advantage claims representing the largest amount. According to researchers, the survey shows limited progress in moving away from fee for service between 2019 and 2020.  Read More

HHS is now distributing $9 billion in payments to healthcare providers affected by the COVID-19 pandemic. The funds will be split among more than 69,000 healthcare providers with the average payment for small providers being $58,000, while the average payment to large providers is $1.7 million.  Read More

The COVID-19 pandemic had a dramatic impact on U.S. healthcare spending in 2020, according to a report recently released by the CMS Office of the Actuary. The report found that U.S. healthcare spending increased by 9.7 percent last year to $4.1 trillion, which breaks down to roughly $12,530 per person. As a result of the sharp increase, healthcare’s share of gross domestic product (GDP) experienced a historic increase from 17.6 percent in 2019 to 19.7 percent in 2020.  Read More

Every other Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, medical billing revenue cycle management, telehealthsecure messaging, clinical communication, and care navigation software.

Here's The Latest in Health Care:


The number of APIs that integrate with certified EHR technology is expected to continue to climb as more developers meet Cures Act requirements. As a result, it should start to become easier for patients to use smartphones, tablets, and desktop apps to access their personal health information from certified EHR systems.  Read More

Telehealth has become a common practice in the last couple of years, but the rules that temporarily eased licensing and reimbursement restrictions in ways that expanded the usage are rapidly shifting. For example, about half of all U.S. states have passed measures keeping audio-only telehealth in place, while the remaining states, absent legislation or old restrictions governing telehealth have either kicked back in or will sunset when the federal public health emergency ends.  Read More

Healthcare systems looking to remedy the fatigue brought on by unwieldy electronic health records systems and mounting staff shortages should explore how the integration of clinical communication and collaboration tools can modernize their workflows and ultimately enhance patient care.  Read More

Health systems are looking at remote patient monitoring as an emerging piece of the care delivery puzzle, but they need help embracing the strategy. Recent moves by the Centers for Medicare & Medicaid Services (CMS) to improve coverage are a step in the right direction, but experts say the effort is still very much a work in progress.  Read More

Every Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, medical billing revenue cycle management, telehealthsecure messaging, clinical communication, and care navigation software.

Here's The Latest in Health Care:


Failing to support the acuity of the medical service rendered with coding and documentation is the number one reason payers deny a hospital claim over a coding issue, according to a new report. Other top causes for denials include if the procedure code is inconsistent with the modifier used or a required modifier is missing, the diagnosis is invalid for the date or dates of service documented, the diagnosis is inconsistent with the procedure, or the diagnosis was not covered at all.  Read More

Nearly one-third of older U.S. adults visit at least five different doctors each year, reflecting the growing role of specialists in Americans' health care according to a new study. On average, beneficiaries saw a 34% increase in the number of specialists they visited each year, while the proportion of patients seeing five or more doctors rose from about 18% in 2000 to 30% in 2019.  Read More

Providers are having a difficult time billing for services related to COVID-19, with 40 percent of charges for coronavirus-related care initially winding up as claim denials in the first 10 months of 2021, according to a recent analysis of more than $100 billion worth of denials and $2.5 billion in audited claims.  Read More

The Centers for Medicare & Medicaid Services has released the final physician fee schedule rule that sets out payment rates for 2022. In addition to including several provisions that aim to expand flexibility for telehealth reimbursement for mental health, including removing geographic restrictions, the rule will also let the 3.75% temporary pay bump given to physicians for 2021 expire.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, medical billing revenue cycle management, telehealthsecure messaging, clinical communication, and care navigation software.

Here's The Latest in Health Care:


Hospital revenue cycle transformation is needed to elevate poor enterprise performance as a result of the COVID-19 pandemic, according to experts from healthcare management consulting firm Kaufman Hall. Three-quarters of hospital and health system leaders said their organization experienced “adverse revenue cycle impacts” during the pandemic, including a higher percentage of Medicaid patients and increased rates of denials.  Read More

While nearly 16% of doctors' visits by seniors were done remotely, either by phone or online over the past two years, the rural elderly appear to be behind the curve, according to a new analysis of telehealth visits billed to Medicare. One-third of rural older adults had at least one virtual visit in 2020, compared with nearly half of seniors in suburban and urban areas.  Read More

The majority of Americans don’t fully understand the information their provider tells them, leading them to consult third-party resources like the internet, a new survey found. In fact, according to the survey, three in four Americans leave the doctor confused and dissatisfied for reasons that include disappointment in the level of Q&A they have with their doctor, confusion about their health, and a need to do more research.  Read More

More physicians are migrating to hospital employment, changing the traditional physician-ownership models of ASCs. According to ASC leaders, there are a number of contributing factors, including the fear of declining reimbursements combined with the complexity of new payment models. Health care has become a "big cap" business requiring market scale, data analytics, and risk management, concepts that small practices are worried they can’t handle on their ownRead More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, medical billing revenue cycle management, telehealthsecure messaging, clinical communication, and care navigation software.

Here's The Latest in Health Care:


Hospital officials say Anthem Blue Cross, the country's second-biggest health insurance company, is behind on billions of dollars in payments owed to hospitals and doctors. Disputes between insurers and hospitals are nothing new, but this fight sticks more patients in the middle, worried they'll have to pay unresolved claims.  Read More

In the latest Medicare Physician Fee Schedule, CMS proposed for the first time a set of charge codes for remote therapeutic monitoring. The inclusion of these codes suggests that transformations in digital health policy initiated in response to COVID-19 are beginning to have some permanence.  Read More

The difference between clean claims and initial claims denials is a major key performance indicator (KPI) that hospitals track, and according to a new survey, nearly 80 percent of hospitals are measuring the difference in the rates. But this KPI may not be the best indicator of revenue cycle health according to the survey authors.  Read More

As COVID-19 continues to overwhelm providers across the country, cybercriminals are increasingly targeting smaller facilities with sophisticated healthcare ransomware attacks that cause EHR downtime and care disruptions. A recent study showed that hackers are turning to outpatient clinics, smaller hospitals, and business associates to target their attacks at unassuming victimsRead More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, medical billing revenue cycle management, telehealthsecure messaging, clinical communication, and care navigation software.

Here's The Latest in Health Care:


Traditionally, healthcare data has centered around clinicians and institutions that largely controlled patient interaction. Lately, however, there has been a shift to consumer-centered systems. This is enabling patients to interact with health professionals and get involved in their own care, leading to greater engagement, improved outcomes and increased satisfaction.  Read More

CMS will begin to reprocess claims for outpatient clinic visit services provided at excepted off-campus provider-based departments, following a reinstated site-neutral payment policy. The agency will start processing the necessary claims, with no action needed on the provider side, by November 1, 2021.  Read More

The Lown Institute, a nonpartisan healthcare think tank, recently unveiled their social responsibility hospital rankings, which is based on 54 metrics across three main categories: equity, value and outcomes. Among the metrics are inclusivity, pay equity, avoiding overuse and clinical outcomes, as well as cost efficiency, a new metric that evaluates how well hospitals achieve low mortality rates at a low cost.  Read More

Sicker patients, fewer outpatient visits, and higher expenses for labor, drugs, and supplies will continue to damage the financial health of hospitals and health systems throughout 2021, says a new analysis released today by the American Hospital Association (AHA). Hospitals nationwide are expected to lose about $54 billion in net income over the course of the yearRead More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, medical billing revenue cycle management, telehealthsecure messaging, clinical communication, and care navigation software.

Here's The Latest in Health Care:


The American Medical Association (AMA) released updates to its medical codes for 2022 with many tied to new technology services and the administration of COVID-19 vaccines. The more than 400 changes include a series of 15 vaccine-specific codes the AMA considers the model for efficiently reporting and tracking immunizations and administrative services against the coronavirus.  Read More

Even though telehealth volumes are expected to decline in the coming months, a recent survey found that many health systems are planning to expand their telehealth services. Chronic care management, behavioral health, and urgent care were the top three service lines cited by survey respondents for the future expansion of telehealth.  Read More

HHS announced the first part of the Surprise Billing Final Rule effective January 1, 2022,  but implementing the requirements under the No Surprises Act is no small feat for provider organizations. Providers need to ensure they are prepared to implement the act in order to uphold these protections and eliminate cost-of-care burdens for their patients.  Read More

The COVID-19 pandemic spurred health systems to adopt new technologies and meet the changing needs of their patients. However, according to Kaufman Hall, greater focus and investments are required for hospitals to compete with heightened consumer expectations, hospital competitors and an expanding list of retail and technology companies entering the space.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, medical billing revenue cycle management, telehealthsecure messaging, clinical communication, and care navigation software.

Here's The Latest in Health Care:


Physician practices are up against a changing healthcare environment and one that has made it harder to survive. Declining reimbursement rates, industry consolidation, and new sites of care delivery are among the latest trends impacting practice management. Practice management best practices can help leaders continue the delivery of high-quality, affordable care while ensuring they can keep the doors of their small business open.  Read More

Reducing the length of stay (LOS) became a major priority for hospitals during COVID-19, and continues to be one as surges continue. Pandemic aside, capitated reimbursement levels and the need to decrease hospital-acquired conditions made LOS reduction key for health systems. While efforts to reduce LOS often focus on specific disease classes, there are general operational factors that are more straightforward to address.  Read More

New research shows that 79% of people who received healthcare services in the past two years experienced an average of three challenges when doing so. Struggles ran the gamut from administrative issues to understanding the care they received itself. Plus, 90% of respondents with complex or ongoing clinical needs faced additional challenges related to tasks such as getting prior authorizations approved.  Read More

The rapid expansion of telemedicine during the pandemic made headlines. What has been overlooked are the changing patterns of its use. According to a recent analysis of 30 million medical claims, which older adults used telemedicine, and how they used it, did not play out exactly as many had expected. Moving forward it will be essential to closely track the evolving use of telemedicine — and which Americans can access their care this way — to ensure that telemedicine does not widen disparities of care.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, medical billing revenue cycle management, telehealthsecure messaging, clinical communication, and care navigation software.

Here's The Latest in Health Care:


A new analysis found that over 100K COVID-19 hospitalizations could have been prevented with vaccines, resulting in billions of dollars in costs for the US health system. With the approximate cost of a coronavirus-related hospital admission being about $20,000, researchers estimated that these preventable COVID-19 hospitalizations cost the US health system $2.3 billion in just June and July alone.  Read More

CMS is encouraging all Medicare Advantage organizations and Medicare-Medicaid plans to waive or relax certain prior authorization requirements amid the COVID-19 surge. In a recent letter, CMS asked these health plans to relax the requirements to facilitate the transfer of patients from acute-care hospitals to post-acute and other clinically appropriate settings.  Read More

At the start of the pandemic, emergency declarations and insurer policies encouraged the shift to telehealth. Telehealth usage has skyrocketed, often leading patients to grow accustomed to relying on virtual care for its convenience and cost-efficiency. Now, as states across the U.S. are putting an end to these policies, telehealth meets one of its biggest hurdles: geographic barriers.  Read More

Hospitals and health systems’ economic recovery hit the brakes in July with mounting COVID-19 admissions, escalating expenses and early evidence that consumers are again postponing elective and outpatient care. Not surprisingly, hospitals in the regions with the highest rates of the variant were most affected in July, and are expected to see those impacts deepen in the months ahead.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, medical billing revenue cycle management, telehealthsecure messaging, clinical communication, and care navigation software.