Revenue Cycle Management

68% of Hospital Execs Plan for 2018 Revenue Cycle IT Budget Growth

by Jacqueline LaPointe

Fewer healthcare organizations are increasing their revenue cycle IT budgets compared to last year, a new survey shows. The annual Healthcare Financial Management Association (HFMA) and Navigant...

Hospital Wage Data Inaccuracies Led to Medicare Reimbursement Issues

by Jacqueline LaPointe

CMS may not be appropriately adjusting Medicare reimbursement to hospitals for local labor prices, a new HHS Office of the Inspector (OIG) report reveals. The HHS watchdog found “significant...

Hospital Operating Income Falls for Two-Thirds of Health Systems

by Jacqueline LaPointe

Health system operating income is deteriorating as hospital expenses continue to grow, according to a recent Navigant analysis. In the three-year analysis of the financial disclosures for 104...

Healthcare Disruption Spurs Hospitals to Alter Business Operations

by Jacqueline LaPointe

Eighty-five percent of hospital and health system executives believe the industry is at significant risk for healthcare disruption, and their organizations are preparing their business operations for...

Atrium Health Settles Anticompetitive Hospital Contracting Claims

by Jacqueline LaPointe

Atrium Health in North Carolina recently agreed to a settlement with the Department of Justice (DoJ) and the North Carolina Office of Attorney General that prohibits the health system from using...

Consumers Seek Care in New Settings for Lower Healthcare Costs

by Jacqueline LaPointe

Consumers are generally comfortable with seeking routine care in healthcare settings beyond the hospital or their doctor’s office if the healthcare costs are lower, data from PwC’s Health...

Hospitals Want Practice Management Systems to Work with EHR, RCM

by Jacqueline LaPointe

Hospitals are seeking customizable practice management systems that integrate with their revenue cycle management and EHR systems, according to a new survey from Black Book Research. Thirty-six...

Court Orders HHS to Eliminate Medicare Appeals Backlog by 2022

by Jacqueline LaPointe

HHS must eliminate the Medicare appeals backlog at the Administrative Law Judge (ALJ) level by the end of the 2022 fiscal year, according to a recent court order. Judge James E. Boasberg of the US...

Price Not the Only Driver of High Healthcare Costs, Research Shows

by Jacqueline LaPointe

Healthcare costs in Colorado are significantly higher compared to other states in the country. A recent analysis by the Network for Regional Healthcare Improvement (NHRI) showed that total cost of care...

Hospital Bankruptcies Are On the Rise, Hitting Rural Areas Hard

by Jacqueline LaPointe

The healthcare industry experience more than 20 hospital bankruptcies since 2016, and about three-quarters of the distressed hospitals operated in rural areas, law firm Polsinelli recently...

Patient Leakage Costs Most Healthcare Facilities 10% of Revenue

by Jacqueline LaPointe

Healthcare organizations are losing revenue because they are failing to properly mange referrals and patient leakage, a new survey shows. Forty-three percent of over 100 executives recently surveyed...

AHA: Consolidated Payer Market Influences Hospital Contracting

by Jacqueline LaPointe

“The overwhelming majority of hospitals and health systems are not the drivers in contract negotiations with commercial health insurers,” the American Hospital Association (AHA) recently...

Aligning the Healthcare Revenue Cycle with Patient Experience

by Jacqueline LaPointe

Improving a patient’s financial experience is key to healthcare revenue cycle management success, according to the Senior Regional Director of Revenue Cycle at Ascension...

Practices Still Averse to Risk-Based Alternative Payment Models

by Jacqueline LaPointe

Physician practices are less willing to participate in alternative payment models with downside financial risk compared to four years ago, revealed a new study from the RAND Corporation and the...

Optum360, WayStar Named Top Revenue Cycle Management Vendors

by Jacqueline LaPointe

The eighth annual revenue cycle management technology and outsourcing solutions survey from Black Book recently uncovered the top client-rated healthcare revenue cycle management vendors for health...

Healthcare Dollars Moving to Alternative Payment Models, LAN Finds

by Jacqueline LaPointe

Approximately 34 percent of all healthcare payments made in 2017 were tied to an alternative payment model (APM) with shared savings, shared risk, bundled payments, or population-based payments,...

4 Hospital Business Models for Consumer-Centric Healthcare

by Jacqueline LaPointe

When a member of Gurpreet Singh’s family broke his wrist, they didn’t go to a hospital emergency room or an academic medical. Instead, the family headed to an urgent care center to triage...

GAO Finds Uptick in Rural Hospital Closures as Inpatient Use Falls

by Jacqueline LaPointe

Sixty-four rural hospitals closed between 2013 and 2017, more than double the number of rural hospitals closures in the prior five-year period, the Government Accountability Office (GAO) recently...

3 Strategies to Minimize the Burden of Prior Authorizations

by Jacqueline LaPointe

Prior authorizations, or prior approvals, are strategies that payers use to control costs and ensure their members only receive medically necessary care. The cost-control process requires providers to...

Implementing a Patient-Focused Culture Good Business for Practices

by Jacqueline LaPointe

Fostering a patient-focused culture was a top business strategy top-performing medical groups and practices implemented in 2018, the Medical Group Management Association (MGMA) recently reported. As...