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

Best Practices

Key Strategies for Health Systems to Achieve Economies of Scale

August 31, 2017 - Companies from across industries use economies of scale to realize cost savings. While hospitals and health systems are borrowing the economic concept to reduce spending, many healthcare organizations have encountered challenges with achieving the benefits of economies of scale. The Healthcare Financial Management Association (HFMA) defines economies of scale as the “gains...


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3 Best Practices for Hospital Claim Denials Management

by Jacqueline LaPointe

Healthcare cost control continued to top hospital priority lists in 2017. But hospital leaders may be leaving millions of dollars on the table because of inefficient claim denials management processes. Claim denial rates ranged between...

Top 5 Ways to Optimize Healthcare Revenue Cycle Management

by Vera Gruessner

Revenue cycle management remains relatively elusive in the new healthcare landscape, as new regulations and reforms have led the industry to evolve and left many hospitals scrambling to keep their revenue strong in a value-based care...

States Could Build Upon the Affordable Care Act to Cut Costs

by Vera Gruessner

The Affordable Care Act has had two main goals for the healthcare system: Increase health insurance coverage for Americans and lower healthcare spending around the country. At this point in time, the Affordable Care Act has brought health...

How to Reduce Wasteful Spending in the Medicare Program

by Vera Gruessner

When the Affordable Care Act was passed several years ago, it had major implications for the future of the Medicare program. According to a study from the Private Enterprise Research Center at Texas A&M University, the Affordable Care...

Why Primary Care Matters in Medicare Shared Savings Program

by Vera Gruessner

The Centers for Medicare & Medicaid Services (CMS) is moving forward with updating the rules and programs around accountable care organizations. The American Academy of Family Physicians  (AAFP) is urging for CMS to include key...

Could More Competition Reduce Rising Prescription Drug Costs?

by Vera Gruessner

Prescription drug costs seem to be higher than ever before. Merrill Matthews, Resident Scholar at the Institute for Policy Innovation, wrote about some of the reasons behind these high prices and the solutions that could lower prescription...

How Automation Technology Could Cut $8 Billion in Healthcare

by Vera Gruessner

One method for better managing the revenue of a hospital and reducing wasteful spending is to reduce manual administrative processes and incorporate automation technology. The 2015 CAQH Index shows that the healthcare industry is...

Payment Reform Strengthens Patient-Centered Medical Home

by Vera Gruessner

The health payer industry and the federal government including the Centers for Medicare & Medicaid Services (CMS) have positioned hospitals, clinics, and medical practices to adopt necessary healthcare payment reform. Alongside...

4 Healthcare Supply Chain Management Tips for Revenue Success

by Jennifer Bresnick

In a healthcare organization, keeping tabs on the ebb and flow of medical supplies is an incredibly important yet often overlooked task.  From syringes and gauze to drugs, disinfectant, and paper gowns, understanding supply chain...

Health Insurance Exchange Tips for Taxpayers Before April 15

by Vera Gruessner

With the deadline for filing this year’s taxes just around the corner, it is useful for insurance consumers to refresh the requirements of tax filing when covered through the health insurance exchange. The majority of people who...

Patient-Centric Strategy Key for Value-Based Care Reimbursement

by Vera Gruessner

As is common in today’s healthcare industry, the move toward value-based care reimbursement has put a greater focus on patient satisfaction and engagement. Quality of care is intrinsically tied to superior health outcomes and patient...

3 Change Management Strategies for Revenue Cycle Results

by Kyle Murphy, T2C Consulting

Healthcare consumers receive the highest quality of service when operational inefficiencies are reduced and business processes are aligned to the goal of that service. That’s true for consumers, but also for providers, third-party...

Is the Medicare Shared Savings Program Cutting Costs?

by Vera Gruessner

The Medicare Shared Savings Program has not, as of yet, reduced healthcare spending for the federal government. Along with the lack of cost savings within the Medicare-sponsored program, Kaiser Health News reports that approximately 50...

How EHR Data Analytics Influences Value-Based Reimbursement

by Jacqueline DiChiara

As the transition away from traditional, fee-for-service payment models towards value-based reimbursement continues, the implementation of electronic health records (EHRs) is becoming the rule rather than the exception. The Centers for...

Why Revenue Cycle Management Needs Electronic Data Exchange

by Jacqueline DiChiara

More focus on electronic data exchange can potentially save healthcare organizations, hospitals, and health systems $8 billion annually, according to a report from the American Hospital Association (AHA). Rising healthcare...

How Do High-Deductible Plans Affect Value-Based Care Goals?

by Jacqueline DiChiara

Value-based care outcomes are shaped by a variety of factors – but especially the ever influential high-deductible health plan (HDHP). The recent significant increase of HDHPs across the healthcare industry is apparently tied...

How Provider Interaction Reduces Claims Reimbursement Waste

by Jacqueline DiChiara

Reducing claims reimbursement waste demands a closer look at the inner workings of the medical billing environment and how to improve provider interactions. A lack of communication may be a leading cause of claims reimbursement waste and...

Why Accountable Care Organizations Need Revenue Cycle Risk

by Jacqueline DiChiara

Is the "Accountable" part of accountable care organizations being ignored? Over 100 new Medicare Accountable Care Organizations (ACO) participants will keep quality high and costs low, according to the Centers for Medicare &...

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