Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Healthcare Revenue Cycle

Staffing Shortages, Healthcare Reform Top C-Suite Concerns

by Jacqueline Belliveau

Healthcare C-suite executives identified staffing shortages and healthcare reform as having the largest impact of their organization’s ability to delivery care, a recent Premier survey found. About 41 percent of the 52 C-suite level respondents...

Price, Utilization Increases Upped Healthcare Spending by 4.5%

by Jacqueline Belliveau

Healthcare spending for privately insured individuals increased by 4.6 percent because of rising prices for outpatient, inpatient, and professional care services as well as prescription drugs, the Health Care Cost Institute (HCCI) recently reported....

OIG Identifies Top HHS Financial, Medicare Fraud Challenges

by Jacqueline Belliveau

The Office of the Inspector General (OIG) recently found the most significant management and performance challenges facing the Department of Health and Human Services (HHS), including financial management and Medicare fraud prevention inefficiencies....

Tips for Negotiating Claims Reimbursement Rates with Payers

by Jacqueline Belliveau

Every dollar counts in the healthcare revenue cycle, especially with declining Medicare reimbursement rates and new value-based care models. But organizations should understand how to successfully negotiate claims reimbursement contracts with...

How to Develop a Value-Based Care Implementation Strategy

by Jacqueline Belliveau

When building a value-based care strategy, healthcare organizations should focus on improving care delivery across skilled nursing facilities, at-home services, and end-of-life services, Steven Strongwater, MD, President and CEO of Atrius Health,...

Health Centers Face Post-ACA Revenue Cycle Management Issues

by Jacqueline Belliveau

Although the Affordable Care Act provided temporary funding to federally qualified health centers, a new study from the UCLA Center for Health Policy Research showed that community health centers will still need funding to resolve healthcare...

Only 23% Have Consumer-Centered Healthcare Capabilities

by Jacqueline Belliveau

While approximately two-thirds of healthcare leaders view consumer-centered healthcare as a priority, especially in light of value-based reimbursement, only 23 percent stated that their organization had the capabilities to develop consumer insights,...

PCP Awareness of Healthcare Costs Cuts Low-Value Resource Use

by Jacqueline Belliveau

Healthcare organizations can cut down on costly low-value services, such as antibiotic prescriptions for acute sinusitis or osteoporosis screenings for young patients, by educating primary care providers about healthcare costs, a recent study...

How to Improve Healthcare Mergers and Acquisitions Strategies

by Jacqueline Belliveau

Large and mid-size healthcare organizations should implement more proactive healthcare mergers and acquisitions strategies to avoid common acquisition mistakes, such as undefined growth strategies and deal overpayments, asserted Deloitte in a...

90% Report Clinical Documentation Improvement Boosted Revenue

by Jacqueline Belliveau

Nearly 90 percent of hospitals with 150 or more beds and outsourced clinical documentation functions realized at least $1.5 million in appropriate healthcare revenue and claims reimbursement following clinical documentation improvement (CDI)...

Benefits, Challenges of Value-Based Health IT Implementation

by Jacqueline Belliveau

From EHR systems to mHealth apps, health IT has the potential to help providers achieve value-based care goals. But with hundreds of new technologies seemingly emerging each day, many providers are struggling to select the most appropriate health...

How Broader Primary Care Teams Can Decrease Healthcare Costs

by Jacqueline Belliveau

Developing broader primary care teams that interact with specific patient populations can save healthcare costs and realize a return on investment, according to a recent PricewaterhouseCoopers (PwC) analysis. For example, a primary care team...

CMS: Rural Healthcare Faces Hospital Revenue Cycle Challenges

by Jacqueline Belliveau

In a statement at the CMS Rural Health Summit yesterday, CMS Acting Administrator Andy Slavitt identified rural communities as one of the biggest opportunities for healthcare reform because rural areas face more hospital revenue cycle challenges,...

How MACRA Implementation Rules Affect Provider Profitability

by Jacqueline Belliveau

New value-based reimbursement models under the Quality Payment Program will launch on Jan. 1, 2017, leaving a couple of months for providers to educate themselves on MACRA implementation rules and prepare their practices for the shift. But taking...

3M, Verily to Create Healthcare Revenue Cycle, Pop Health Tool

by Jacqueline Belliveau

3M Health Information Systems recently partnered with Verily Life Sciences to develop a technological platform that providers and payers can use to analyze population health measurements to better assess clinical and healthcare revenue cycle...

Black Book Names Optum360 Top HIM, Coding Outsourcing Vendor

by Jacqueline Belliveau

Optum360 earned the top spot for health information management (HIM) and computer-assisted coding outsourcing vendor among hospital chains, systems, corporations, and integrated delivery networks as well as independent inpatient facilities, according...

How Value-Based Reimbursement Affects Physician Productivity

by Jacqueline Belliveau

As payers push for more value-based reimbursement adoption, many healthcare organizations are wondering how to restructure physician productivity strategies to meet the unique requirements of performance-based payments. But the key to success...

Appeals Court Supports FTC Request to Stop PA Hospital Merger

by Jacqueline Belliveau

A federal appeals court recently reversed a lower court’s decision to deny the Federal Trade Commission’s (FTC) request to temporarily pause the hospital merger between Penn State Hersey Medical Center and PinnacleHealth System until...

Cerner Earns Top Revenue Cycle Management Outsourcing Vendor

by Jacqueline Belliveau

Black Book Market researchers ranked Cerner Business Office Services as the top rated end-to-end physician revenue cycle management outsourcing vendor. Cerner earned high marks on eighteen key performance indicators relating to client experience...

Health Systems, Physicians See Significant Revenue Losses in 2015

by Jacqueline Belliveau

Both integrated healthcare systems and private physician practices saw operating losses in 2015, according to a revenue cycle management survey conducted by the American Medical Group Association. Integrated healthcare systems saw an operating...

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