The Role of Finance, Revenue Cycle in Advancing Health Equity
RevCycleIntelligence 2020 was a pivotal year for healthcare. Not only did the industry face the worst public health crisis in modern history, but it, like the country at large, also came up against a historic social movement spurred by the death of George Floyd. “We were all literally sitting and bearing witness to the life as we knew it change before our very eyes,” Tammie L. Jackson, FHFMA,...
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How E/M Coding Changes Became an Urgent Problem for a TN Clinic
The past year has been tough for AFC Urgent Care Memphis, Tennessee. Like most practices, the small urgent care clinic saw patient volume dip dramatically at the start of the COVID-19 pandemic. And like their peers, this all happened...
Value-Based Contracting 101: Preparing, Negotiating, and Succeeding
The Triple Aim. The Quadruple Aim. Right care at the right place at the right time. Whether one works in a hospital or small independent practice, healthcare providers are leaning on these concepts to deliver valuable care to their...
Top Challenges, Opportunities of Medical Coding and Billing
By April of last year, seemingly every news station in American was featuring the heroic efforts of physicians, nurses, and other clinicians fighting COVID-19. These providers transformed healthcare, implementing telehealth and virtual...
Underserved Areas Get Higher CARES Act Provider Relief Payments
At the start of the COVID-19 pandemic, the healthcare industry was confused, scrambling, and scared. Patients did not know when and where it was safe to seek care and providers were overwhelmed with patients needing care for a disease they...
What Healthcare CFOs Can Expect Under a Biden Presidency
For many voters, the 2020 presidential election was less about red and blue and more about white, as in the white coat. Healthcare was a dominant issue in the race between the incumbent President Donald J. Trump and Democratic runner Vice...
Best Practices When Outsourcing Revenue Cycle Management
Mission statements from healthcare organizations come in many shapes and sizes, but at the heart of all those missions is the intention to provide high-quality, patient-centered care that improves the health of those served by the provider....
How Top Accountable Care Organizations Save Year After Year
Accountable care organizations had a record year, according to the latest performance data for the Medicare Shared Savings Program. CMS recently announced that organizations participating in the program – which are otherwise known as...
Can Direct Primary Care Lead Private Practice Out of the Hole?
It took two surgeries, nine doctors, and over a decade of care for Ashlie Olp to get a diagnosis for persistent leg pain. The overall patient experience was frustrating for Olp, a physician herself who was working at a private family...
Healthcare Revenue Cycle Recovery After the COVID-19 Pandemic
Halfway through 2020, hospitals have been doing the unimaginable. Patients have been asked to avoid healthcare facilities when possible, while more visits have been done via smartphones and laptops than in exam rooms. Meanwhile, some...
How COVID-19 Imperiled Physician Practices, And How to Save Them
Some have heard the ringing of the death knell for physician practices for years now. Mergers and acquisitions, industry consolidation, value-based care, and the growing presence of private equity firms in healthcare have all threatened the...
How Artificial Intelligence Is Optimizing Revenue Cycle Management
Prior authorizations are one of the most burdensome aspects of revenue cycle management. In a survey of 1,000 practicing physicians conducted by the American Medical Association (AMA), 86 percent of doctors described the burden of prior...
4 Key Strategies for Accountable Care Organization Success
The passage of the Affordable Care Act sparked many innovative care delivery and payment reform models. One unique model that emerged from this trend was the accountable care organization (ACO). In this model, groups of doctors, hospitals,...
Entering the Next Phase of Value-Based Care, Payment Reform
“What healthcare providers really want is to do is the right thing for their patients. They just need sustainable financial support for doing that,” health economist Mark McClellan, MD, PhD, said at the start of an interview...
Value-Based Payment Opens Doors for Better Opioid Use Disorder Care
Nearly 64,000 Americans died from a drug overdose in 2016 alone, with opioid overdoses representing over 42,000 of those deaths, more than any previous year on record. It was that figure – as well as many other troubling statistics...
Healthcare CFOs Look Forward to Value-Based Care, Consumerism
Chief financial officers are an organization’s financial gatekeeper, looking back at data to understand company performance, set and keep budgets, manage risk, and track cash flow. While these lookbacks ensure the company remains...
How Downside Risk Will Impact Participation in Pathways to Success
Providers queued up eagerly to partake in the Medicare Shared Savings Program when the rewards outweighed the risks, but many accountable care organizations exited the program as the balance of risk shifted to their perceived disadvantage....
Going Above and Beyond the CMS Hospital Price Transparency Rule
As of January 1, 2019, a new CMS hospital price transparency rule requires all hospitals in the US to publicize what was once considered heavily guarded material: their chargemasters. Chargemasters are lists of all the services and items...
Patient Financial Experience the New Focus for Revenue Cycle Tech
Hospitals and practices have traditionally relied on public and private payers to cover the bulk of patient charges and costs for their services. Everything from their revenue cycle technologies to billing workflows has been tailored to...
Optimizing Healthcare Workforce Management for High-Value Care
Investing in high-quality clinicians and staff enables healthcare organizations to deliver the highest value care to their patients. But the growing physician shortage and the increasingly competitive healthcare industry are making it...
