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

Healthcare Revenue Cycle

Exploring Key Components of the Healthcare Revenue Cycle

August 21, 2017 - The healthcare revenue cycle encompasses “all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue,” according to the Healthcare Financial Management Association (HFMA). But the cycle traditionally contains distinct areas that oftentimes function separately from each other. A traditional healthcare revenue cycle...

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Top 10 Enterprise Resource Planning (ERP) Vendors By Hospital Use

by Jacqueline Belliveau

Healthcare providers have become increasingly interested in implementing enterprise resource planning (ERP) systems as part of their business intelligence and revenue cycle management suites. ERP systems are business management tools that give...

Small Health System Achieves ROI with Asthma Management Clinic

by Jacqueline Belliveau

Asthma is one of the most expensive chronic diseases for providers, payers, and patients. But a recent study in the American Journal of Managed Care showed that a stationary pediatric asthma management clinic can achieve a return on investment...

NYC Health’s ERP System to Bring Business Ops to Digital Age

by Jacqueline Belliveau

From payroll and workload management to orders and purchasing, health systems manage a myriad of back-end business operations, using a combination of automated systems as well as manual processes associated with each function. The web of disparate...

Medicare Reimbursement Add-On to Boost Palliative Care Revenue

by Jacqueline Belliveau

A recent study in the Journal of Palliative Medicine showed that providers should be leveraging a supplemental Medicare reimbursement to enhance palliative care in the last seven days of life. CMS pays providers for furnishing routine home care...

Skilled Nursing Facilities See $370M Medicare Reimbursement Bump

by Jacqueline Belliveau

Skilled nursing facilities are slated to receive a 1 percent increase in Medicare reimbursement in 2018, representing $370 million more dollars in healthcare payments, CMS recently announced in a final rule. While CMS finalized Medicare reimbursement...

Volume, Value of Healthcare Merger and Acquisition Deals Up

by Jacqueline Belliveau

Healthcare merger and acquisition activities among hospitals were up 15 percent in the second quarter of 2017 compared to the same quarter the previous year, recent research from Kaufman, Hall & Associates, LLC showed. The number of transactions...

Healthcare Revenue Cycle Software Market to Grow at 4.5% CAGR

by Jacqueline Belliveau

The healthcare revenue cycle management software market is slated to grow at a modest compound growth rate (CAGR) of 4.5 percent between 2017 and 2021, stated a recent Research and Markets report. “The latest trend gaining momentum in the...

Free Health Clinics Face ROI, Clinical Efficiency Obstacles

by Jacqueline Belliveau

Free health clinics help uninsured and low-income individuals access affordable care, but two recent studies show that free clinics may face healthcare costs and clinical efficiency challenges. New research in the Journal of the American Board...

Geisinger Lowers Turnover for Healthcare Revenue Cycle Success

by Jacqueline Belliveau

A MAP Award for High Performance in Revenue Cycle from the Healthcare Financial Management Association (HFMA) indicates that a health system achieved outstanding healthcare revenue cycle performance on metrics such as net days in accounts receivable...

Making a Business Case for the Patient-Centered Medical Home

by Jacqueline Belliveau

Transforming primary care practices to patient-centered medical homes (PCMHs) and maintaining National Committee for Quality Assurance (NCQA) recognition cost a large physician network about $2.5 million, or $43,000 per practice, revealed a new...

Greater Non-Physician Staffing Helps Healthcare Revenue Cycle

by Jacqueline Belliveau

Increasing the number of non-physician providers and support staff, such as physician assistants and nurse practitioners, is key to healthcare revenue cycle performance, a recent MGMA survey revealed. The survey of over 2,900 medical groups across...

GAO Identifies VA Provider Productivity Measure Shortcomings

by Jacqueline Belliveau

The VA lacks appropriate provider productivity measures and clinical efficiency models to accurately capture medical center performance, the Government Accountability Office (GAO) recently reported. A review of the VA Central Office and six VA...

Healthcare Costs Up 47.2% Despite Little Change in Utilization

by Jacqueline Belliveau

Healthcare costs increased 47.2 percent from $246 per individual per month in 1996 and 1997 to $362 per individual per month in 2011 and 2012 despite healthcare utilization and the number of individuals seeking care remaining relatively unchanged...

Group Purchasing Increases Healthcare Supply Chain Savings

by Jacqueline Belliveau

Group purchasing organizations (GPOs) increased healthcare supply chain savings between 10 percent and 18 percent by reducing transaction costs and supplier prices, a recent Healthcare Supply Chain Association (HSCA) study revealed. The literature...

Provider Profitability Drops Under Biosimilar Use Reimbursement

by Jacqueline Belliveau

Biosimilar use could be the key to lowering healthcare costs associated with biologic treatments, but provider profitability may suffer by as much as $100 million across care settings if providers continue to administer the low-cost alternative,...

PCP Patient Attribution Aids Providers in Value-Based Contracts

by Jacqueline Belliveau

Healthcare providers engaging in value-based contracts with shared savings opportunities earn financial bonuses or receive penalties based on the patients linked to them or their provider system. But which patient attribution model provided the...

Long Wait Times Jeopardize Value-Based Purchasing Revenue

by Jacqueline Belliveau

Fee-for-service payment models promote long patient wait times, but providers may want to consider implementing strategies to reduce wait times to increase market share and revenue under value-based purchasing models, argued two Geisinger Health...

Proactive Healthcare Charge Integrity Captures Missed Revenue

by Jacqueline Belliveau

The key to a successful healthcare charge integrity initiative is the ability to trend chargemaster and coding data, stated Harriett Johnson, the Assistant Director of Revenue Integrity at Novant Health. The trending capability allows health...

41% of Rural Hospitals Operating with Negative Margins

by Jacqueline Belliveau

Approximately 41 percent of rural hospitals faced negative operating margins in 2016, a recent Chartis Group and iVantage Health Analytics study of over 2,100 rural hospitals revealed. Researchers added that rural hospitals located in states...


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