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

Revenue Cycle Management Interviews

“Just the Beginning” of Healthcare Price Transparency, Verma Says

by Jacqueline Belliveau

Requiring hospitals to post a list of their standard charges online is just the beginning of the push for increased healthcare price transparency by CMS, explained the federal agency’s Administrator Seema Verma. “As people are paying...

Gaining Visibility into Healthcare Workforce Management Cuts Costs

by Jacqueline Belliveau

If it takes a village to raise a child, then it may take an entire city to operate a health system. From executives and clinicians to IT managers and front desk staff, healthcare workforce management involves hundreds to thousands of employees...

RFID, Smart Cabinets Improve Hospital Supply Chain Management

by Jacqueline Belliveau

From EHR systems and revenue cycle management tools to data analytics and online patient payment options, hospitals and health systems are on the journey to automating all aspects of the healthcare experience. However, the hospital supply chain...

Real-Time Insights into Nursing Workflow Maximizes Productivity

by Jacqueline Belliveau

An elderly patient presses the nurse call button to get assistance with standing up and using the toilet, while another patient in the next room presses the button to get help with changing the TV channel. Further down the hall, lights turn on...

OR Efficiency, Machine Learning Boosts UCHealth’s Revenue by $10M

by Jacqueline Belliveau

Moving from traditional block scheduling for the operating room (OR) to more of a service-based system that used machine learning maximized OR efficiency and increased revenue by $10 million across UCHealth’s University of Colorado Hospital...

Bringing Profee, Facility Together to Maximize Coding Productivity

by Jacqueline Belliveau

Professional and facility coding describe two very different aspects of a healthcare. But breaking down the wall between the departments has the potential to boost coding productivity and improve clean claim rates. While professional codes primarily...

Transforming the Hospital Laboratory into a Profit Center

by Jacqueline Belliveau

Hospital and health system executives are missing an opportunity to maximize revenue cycle and operational success by viewing the hospital laboratory as a cost, rather than profit, center, explained Charles Wilson, MHA, Vice President of Operations...

A Holistic View of the Patient Enables Risk-Based ACO Success

by Jacqueline Belliveau

Giving providers a holistic view of the patient resulted in accountable care organization (ACO) success for a risk-based organization in southern Florida, which earned a place on the list of ACOs achieving the greatest shared savings in the Medicare...

Slow and Steady Still the Motto for Value-Based Reimbursement

by Jacqueline Belliveau

The healthcare industry has boarded the train to value-based reimbursement. But recent roadblocks have provider organizations pumping the brakes with the shift away from fee-for-service, explained industry experts Doral Jacobsen, MBA, FACMPE,...

Patient Education Boosts Revenue, Quality for Joint Replacements

by Jacqueline Belliveau

Offering interactive patient education pre- and post-total joint replacement surgery is key to improving patient outcomes and generating new revenue, a multi-specialty hospital system in the Twin Cities area recently found. An estimated 7 million...

Prehabilitation Lowers Episode Costs Under Bundled Payment Models

by Jacqueline Belliveau

Dedicating even a couple hours to helping patients understand and prepare for a procedure prior to surgery can save providers millions under bundled payment models, explained healthcare industry expert and former CMS official Charlene Frizzera....

Reducing Low-Value Care Key to Value-Based Reimbursement Success

by Jacqueline Belliveau

Value-based reimbursement success hinges on decreasing low-value care across patient populations, explained Scott Weingarten, MD, MPH, Senior Vice President and Chief Clinical Transformation Officer at Cedars-Sinai Medical Center. While hospitals...

Consolidated Medical Billing Boosts Collections for a TX Group

by Jacqueline Belliveau

Providing a unified medical billing experience was key to improving patient collections by 24 percent in one year at the largest independent multi-specialty physician group in Abilene, Texas. Abilene Diagnostic Clinic boasts 30 physicians and...

Team-Based Care for Kidney Disease Saves Park Nicollet $1.2M

by Jacqueline Belliveau

End-stage renal disease comes with a hefty price tag for both patients and providers. But Park Nicollet Health Services, an integrated care system in Minnesota, found that a team-based care approach to late-stage kidney disease helped to drastically...

How Mercy Improved Care Transitions for Risk-Based Care Success

by Jacqueline Belliveau

For the thousands of patients released from their 23 acute care hospitals a year, Mercy Health ensures that each patient receives the highest value care. But there is only so much providers can do within the walls of their health system to extend...

Predictive Analytics Improve Nursing Schedules, Saving Mercy $4.3M

by Jacqueline Belliveau

Even with 40,000 physicians, nurses, and other employees, St. Louis-based Mercy still relied on staffing agencies and employee incentives to fill critical nursing schedule gaps until a predictive analytics platform helped operations leaders to...

Value-Based Contracts Rely on Patient Attribution, Data Sharing

by Jacqueline Belliveau

CMS aims to tie 90 percent of Medicare fee-for-service payments to quality by the end of 2018, with one-half of those payments to be paid under a value-based contract with some degree of financial risk. With ambitious goals from the federal government,...

Addressing Quadruple Aim, Physician Burnout Key to Risk Success

by Jacqueline Belliveau

From capturing patient risk to meeting quality measures, providers face a daunting list of items needed to achieve the Triple Aim of value-based care. But healthcare organizations will not see lasting cost savings and care quality improvements...

Automating Healthcare Contract Management Improves Business Ops

by Jacqueline Belliveau

Improving care access at hospitals is key to ensuring the health of pregnant women and their babies. But the business operations behind improving care access, such as employee and vendor contract management, must be as efficient as possible to...

The Pros and Cons of Quality Measure Choices In MACRA, MIPS

by Jacqueline Belliveau

Uprooting the fee-for-service payment system and changing the way clinicians provide care is no easy feat. With this in mind, CMS designed MACRA’s Merit-Based Incentive Payment System (MIPS) to gradually ramp up participation and offer...

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