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.
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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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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.
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