ACOs Improve Quality, Physician Burnout As New Opportunities Emerge
RevCycleIntelligence Accountable care organizations (ACOs) aim to improve healthcare quality for patients while reducing costs. Even as healthcare providers have operated in an unstable industry for the past few years, ACO programs have continued to achieve shared savings and promote the shift to value-based care. Programs like the Medicare Shared Savings Program (MSSP) and Direct Contracting—soon to...
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Healthcare Compliance Will Be a Challenge in Post-PHE World
The COVID-19 public health emergency (PHE) declaration was accompanied by several waivers and flexibilities that made it easier for healthcare providers to care for patients amid a global pandemic. Expanded telehealth coverage, Stark Law...
Predictive Analytics Streamline Hospital Operations at Seattle Children’s
There are several Seattle Children’s Hospitals. No, you can’t physically go to these other “hospitals” for world-class pediatric care, but the organizations are helping to make Seattle Children’s more...
From Head in the Clouds to On the Ground Cloud-Based Revenue Cycle Management
If you suggested moving healthcare data to the cloud a couple of years ago, healthcare leaders would have told you to get your head out of the clouds. Now, that is precisely where cloud-based health IT systems are being deployed: on the...
Revenue Cycle Technology Key to Patient Collections, Experience
Revenue cycle technology is helping Hackensack Meridian Health become a high-performing healthcare organization, especially when it comes to patient collections and financial experience. “We do not want manual processes in the revenue...
Will Medicare Physician Fee Schedule Changes Drive Value-Based Care?
The proposed changes in the Medicare Physician Fee Schedule (PFS) for calendar year (CY) 2023 may offer incentives for provider groups to consider alternative payment models. Still, the policies will likely require more apparent benefits to...
Bayhealth’s ERP Implementation Improves Supply Chain Management
EHRs revolutionized how healthcare providers deliver care. The technology has brought many providers into the digital age, enabling not only electronic medical records but also a host of other health IT applications. Now that most...
Key Challenges, Strategies for Patient-First Billing
Patients always come first in healthcare. However, patient-first billing is still a relatively new concept for provider organizations. “Self-pay A/R is really shifting with high-deductible health plans,” explains Adrienne...
Opportunities, Challenges of Value-Based Care Adoption
Kenneth L. Davis, MD, believes that keeping patients healthy and ultimately out of the hospital is the key to making healthcare more affordable. That is why he is leading one of the nation’s top health systems down the path of...
More Residency Slots Could Mitigate FL’s Projected Physician Shortage
Increasing the number of residency slots may be the key to preventing the substantial physician shortage Florida is projected to experience in the upcoming years. A report prepared for the Safety Net Hospital Alliance of Florida revealed...
Efficient Data Sharing Needed for Value-Based Care Transition
The COVID-19 pandemic changed how healthcare organizations approach care delivery, but the industry needs more efficient and transparent data sharing methods to accelerate provider transition to value-based care models. Providers and payers...
Assessing Progress on the Hospital Price Transparency Rule
The Centers for Medicare and Medicaid Services (CMS) established the hospital price transparency rule to help individuals know the cost of a hospital item or service before receiving it. CMS proposed the price transparency rule in the 2020...
How Healthcare Mergers, Acquisitions Impact Practice Management
Healthcare mergers and acquisitions further industry consolidation by combining two or more healthcare companies, hospitals, or physician practices. Typically, merging entities aim to lower healthcare costs and improve quality of care...
Breaking Down Common CMS Value-Based Payment Programs
Value-based payment programs tie healthcare reimbursement rates to quality care by offering providers incentive payments to meet specified quality measures during and after healthcare delivery. As the industry moves away from...
Coronavirus Healthcare Spending Dwindles, Threatening Health Equity
The coronavirus pandemic spawned a wave of government spending that increased health equity for uninsured or underprivileged people and encouraged access to care for all. That wave of funding is now drying up, with billions of dollars set...
What Is Value-Based Care, What It Means for Providers?
Value-based care is a form of reimbursement that ties payments for care delivery to the quality of care provided and rewards providers for both efficiency and effectiveness. This form of reimbursement has emerged as an alternative and...
Exploring the Fundamentals of Medical Billing and Coding
Medical billing and coding translate a patient encounter into the languages healthcare facilities use for claims submission and reimbursement. Billing and coding are separate processes, but both are necessary for providers to receive...
What Is Healthcare Revenue Cycle Management?
While hospitals, small practices, and larger healthcare systems are known for saving lives and treating patients, every healthcare organization needs to develop successful processes and policies for staying financially healthy. That is...
Top Healthcare Fraud, Waste, and Abuse Takedowns of the Year
Healthcare fraud, waste, and abuse continue to be a problem for public and private programs. Each year, the Department of Justice (DoJ) reports on the major cases and takedowns involving physicians, pharmacists, and other medical providers....
The State of Value-Based Reimbursement, Financial Risk in Healthcare
Most healthcare payments made in 2020 were tied in some way to value or quality of care, according to the latest data from the Health Care Payment Learning & Action Network (LAN). The LAN’s latest APM Measurement report showed...
