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

Healthcare Revenue Cycle

Care Standardization Key to Healthcare Revenue Cycle Excellence

June 20, 2017 - To be named a top health system by Truven Health Analytics and IBM Watson Health, it takes a range of clinical quality improvements and healthcare revenue cycle efficiencies. But for St. Luke’s Health System, one of 15 top health systems in 2017, it started with care standardization. Bart Hill, MD, the Idaho-based health system’s Vice President and Chief Quality Officer, attributed...

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ACOs Restructure Healthcare Staffing for High-Risk Patients

by Jacqueline Belliveau

To successfully lower healthcare costs while improving care quality, accountable care organizations (ACOs) have restructured their healthcare staffing models to provide additional support to high-risk patients, a recent American Journal of Accountable...

96% of Healthcare Execs Report Rise in Inpatient Drug Spending

by Jacqueline Belliveau

Approximately 64 percent of healthcare executives reported that inpatient drug spending at their organization significantly increased over the past five years, a recent Premier Inc survey revealed. Another 32 percent said that it somewhat...

Optimizing RCM During Value-Based Reimbursement Transition

by Jacqueline Belliveau

Value-based reimbursement revolutionized how providers get paid for care delivery. However, the slow push away from fee-for-service payments has challenged providers looking to optimize healthcare revenue cycle management. To advance healthcare...

Provider Collaboratives Combat Healthcare Merger Pressures

by Jacqueline Belliveau

Value-based reimbursement continues to drive healthcare merger and acquisitions activities. But hospitals and health systems can remain independent and achieve healthcare cost reduction and value-based reimbursement goals by joining a provider...

52% of Provider Compensation Bonuses Tied to RVUs, Not Quality

by Jacqueline Belliveau

Approximately 52 percent of provider compensation offers with a production bonus in 2017 based the additional pay on relative value units (RVUs), while just 39 percent used quality metrics, a recent Merritt Hawkins survey found. The study of...

Healthcare Employment Shifting to Hospital-Employed Providers

by Jacqueline Belliveau

Physician practice owners no longer make up the majority of patient care providers, a recent American Medical Association (AMA) healthcare employment study revealed. Approximately 47 percent of patient care providers had a full or part ownership...

86% of Providers Saw Prior Authorization Requirements Increase

by Jacqueline Belliveau

Approximately 86 percent of medical practice leaders reported that prior authorization requirements have increased over the past year, a recent MGMA survey of over 1,000 leaders found. Only 3 percent stated that prior authorization requirements...

Lab Experts Help Providers Reduce Low-Value Resource Use, Costs

by Jacqueline Belliveau

Collaboration between laboratory medicine experts and clinicians is critical to reducing unnecessary and low-value resource use for value-based purchasing success, the American Association For Clinical Chemistry (AACC) recently stated. “The...

Only 40% of ED Providers Identified Accurate Healthcare Costs

by Jacqueline Belliveau

Emergency department providers have little understanding of the healthcare costs associated with common visits, a recent Journal of the American Osteopathic Association study revealed. The survey of over 400 healthcare professionals working in...

Commitment Key to Successful Value-Based Reimbursement Adoption

by Jacqueline Belliveau

It is time for healthcare providers to move past understanding the concept and start the value-based reimbursement adoption process. Otherwise, they may face profitability decreases from operating both fee-for-service and alternative payment...

Surviving Solo with Independent Practice Association Support

by Jacqueline Belliveau

Healthcare reform and market forces are driving more independent practice leaders to consolidate with larger hospitals or health systems. But an independent practice association, like Vermont’s HealthFirst, can help solo providers leverage...

Healthcare Framework Aims to Drop Low-Value Resource Use, Costs

by Jacqueline Belliveau

Healthcare organizations looking to reduce low-value resource use and healthcare costs should implement a framework that addresses the patient and clinician interaction, according to a recent Journal of Hospital Medicine report. Four physicians...

Physician Alignment Drives Healthcare Revenue Cycle Progress

by Jacqueline Belliveau

Hospital and health system leaders frequently rank decreasing healthcare costs and increasing efficiency as their top concerns year-after-year. But many healthcare organizations have struggled to implement and sustain healthcare cost reduction...

Medicare Appeals Backlog Delays Decision Process By 4.5 Years

by Jacqueline Belliveau

Hospitals waited an average of 1,663.3 days, or a little over 4.5 years, to conclude the Medicare reimbursement audit and appeals process because of the extensive Medicare appeals backlog, a recent Journal of Hospital Medicine study uncovered....

Do NP, PA Ordering Habits Lead to Higher Healthcare Costs?

by Jacqueline Belliveau

Nurse practitioners and physician assistants did not contribute to higher healthcare costs by ordering more ancillary or expensive services compared to primary care providers, a recent American Journal of Managed Care study uncovered. The analysis...

56% of Top Performing Med Groups Plan Value-Based Purchasing

by Jacqueline Belliveau

About 56 percent of medical groups that were financially high-performing have a plan for a value-based purchasing transition versus just 32 percent of medical groups falling behind with healthcare revenue cycle management, a recent CareCloud...

House Reps Address Physician Shortage in Medicare Residency Bill

by Jacqueline Belliveau

House representatives Joseph Crowley (D-NY) and Ryan Costello (R-PA) recently introduced legislation that aims to resolve physician shortage challenges by adding more Medicare-funded residency positions. A summary of the Resident Physician Shortage...

Post-Acute Care Network Key to Value-Based Purchasing Success

by Jacqueline Belliveau

Health systems should develop a post-acute care network and strategy to succeed in value-based purchasing models, a recent Deloitte survey indicated. The survey of 36 executives from health systems, payers, post-acute care organizations, and...

High-Cost Patients Widely Distributed Across Hospitals, Markets

by Jacqueline Belliveau

A recent American Journal of Managed Care study attempting to understand why some patients incur higher healthcare costs than others found that high-cost patients were evenly spread across providers and healthcare markets. Using a 20 percent...


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