Features

What’s Behind Private Equity’s Interest in RCM Vendors

RevCycleIntelligence A major offer from a private equity firm is making waves in the revenue cycle management (RCM) vendor space, showcasing private equity’s interest in RCM vendors and software. New Mountain Capital, a private equity and capital firm headquartered in New York, recently offered to buy all of R1 RCM’s outstanding shares not currently owned by investors. The firm, which already has...


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How Can Providers Establish Successful Accountable Care Organizations?

Accountable care organizations (ACOs) are a common way healthcare providers can transition from fee-for-service to value-based care delivery. In ACOs, providers come together to deliver quality coordinated care to patients while usually...

How Robotic Process Automation Optimizes Revenue Cycle Management

Revenue cycle management technology comes in all shapes and sizes depending on a healthcare provider’s goals. One of the more popular forms of technology in RCM is robotic process automation (RPA). RPA is a technology that leverages...

Breaking Down the Back-End Revenue Cycle, Key Best Practices

The healthcare revenue cycle is a continuous process that relies on each step to keep revenue flowing. However, many organizations break down the revenue cycle into front- and back-end steps to manage what happens before and after a patient...

From Pilot to Scale, Mount Sinai Leverages Autonomous Medical Coding

An experiment to streamline medical coding is set to take off at Mount Sinai Health System. The academic medical system nestled in the New York metropolitan area recently implemented autonomous medical coding within its pathology department...

Top Trends in Automation, AI Adoption in Revenue Cycle

Automation has a lot of potential to streamline revenue cycle management, and healthcare organizations are certainly interested in adopting technology to achieve efficiency. However, that interest is not necessarily turning into investment...

Highlighting Top Revenue Cycle Management Vendors By User Review

Epic, Experian Health, and Waystar are just some of the revenue cycle management vendors performing well across various operations. The 2024 Best in KLAS Software & Services report highlights the top vendors in claims management,...

Overcoming the Barriers to Value-Based Payment in Primary Care

Primary care is arguably the most critical component of our healthcare system. Primary care and preventive medicine can help avert and manage chronic diseases and prevent long-term complications. However, efforts to improve primary care...

How AI is Becoming a Staple in Medical Coding, Auditing

Troves of data flow through the healthcare revenue cycle. Yet, many providers struggle to make sense of the codes and clinical documentation to not only submit clean claims but also understand patient encounters that occur within their...

How to Adapt as Healthcare Workforce Management Shifts

There’s a significant workforce crisis in healthcare right now, according to Sarah Nosal, MD, FAAFP, a family physician and a member of the board of directors at the American Academy of Family Physicians (AAFP). Nosal, who also serves...

How a GoFundMe Page Aims to Keep a Rural Hospital Open

When financial troubles turned dire, leaders of a rural hospital turned to a popular source of funding to support their efforts to get back on their feet: GoFundMe. Crowdfunding platforms like GoFundMe are popular among individuals looking...

Key Considerations For Choosing a Revenue Cycle Technology Vendor

Revenue cycle technology is not one size fits all. Whether a solution promises to ease patient collection woes or streamline claims management processes, healthcare providers must do their due diligence to select the revenue cycle...

The Role of the Hospital Chargemaster in Revenue Cycle Management

The hospital charge description master, or hospital chargemaster, is at the heart of the healthcare revenue cycle, serving as the hospital’s starting point for billing patients and payers. A hospital chargemaster lists all the...

Understanding the Value-Based Reimbursement Model Landscape

The Centers for Medicare and Medicaid Services (CMS) aims to have all traditional Medicare beneficiaries under a value-based care model by 2030. Although the pace may be slow, the healthcare industry is shifting away from fee-for-service...

How Nursing Homes Can Prepare for Staffing Standards, Gaps

After experiencing the brunt of the COVID-19 pandemic, long-term care facilities have prioritized strategies to improve staffing levels and care quality. The federal government has taken action, too, proposing minimum staffing standards for...

Understanding the Fundamentals of Accountable Care Organizations

The healthcare payment process is undergoing a dramatic transformation as payers and providers shift from volume to value. While stakeholders are currently piloting many value-based care models, accountable care organizations (ACOs) are...

Overcoming the Barriers to AI Adoption in Revenue Cycle Management

About a third of hospital financial leaders have never used automation in revenue cycle operations. Nearly two-thirds of hospitals haven’t automated any part of claims denial management. And approximately a third of prior...

Value-Based Reimbursement Grows as Providers Take on More Risk

Over half of healthcare payments last year were made through value-based reimbursement models, with most of those payments tied to some degree of financial risk, according to the latest data from the Health Care Payment & Learning...

Generative AI’s Potential Shines on Revenue Cycle Management

Healthcare has its eyes on generative artificial intelligence (AI). The technology, including the popular ChatGPT tool, has passed medical exams, diagnosed complex cases, and designed new ways to combat COVID-19. However, its most promising...

Unlocking the Future of Value-Based Care With Data

Advocate Health is a value-based care leader. More than 2.4 million lives are covered by the health system’s value-based care contracts, which include 12 different accountable care organizations (ACOs) and clinically integrated...