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

Healthcare Revenue Cycle

31% of Providers Still Use Manual Claims Denial Management

by Jacqueline Belliveau

As the transition to value-based care carries on, many healthcare providers are reexamining their current healthcare revenue cycles to account for new alternative payment models. With providers experiencing an increase in claims denials and denial...

CMS: Proposed Changes to Dialysis, ESRD Claims Reimbursement

by Jacqueline Belliveau

The Centers for Medicare and Medicaid Services (CMS) has recently announced proposed changes to claims reimbursement models for end-stage renal disease (ESRD) and dialysis as well as revisions to the competitive bidding program for durable medical...

74% of Providers See Increased Patient Financial Responsibility

by Jacqueline Belliveau

A recent report from InstaMed found that 74 percent of healthcare providers reported an increase in patient financial responsibility in 2015, which has prompted healthcare revenue cycle management strategies to focus more on consumers. “With...

Ambulatory Surgery Centers Help Reduce Healthcare Costs

by Jacqueline Belliveau

With a push for more healthcare transparency, more beneficiaries are now equipped to reduce healthcare costs by selecting the cheapest option for medical services. However, some providers may not be as lucky since site of care can create significant...

Coding Productivity Fell by 14% After ICD-10 Implementation

by Jacqueline Belliveau

As the anniversary of ICD-10 implementation approaches, a survey from the American Health Information Management Association (AHIMA) Foundation has revealed that coding productivity and accuracy has marginally declined since ICD-10 began. “Health...

Survey: Value-Based Reimbursement to Eclipse FFS by 2020

by Jacqueline Belliveau

As federal agencies and commercial payers push to eliminate fee-for-service payment models, value-based reimbursement structures have been on the top of most healthcare provider and payer agendas. The majority of healthcare providers and payers...

Detailing ACO Challenges with Risk, MACRA Implementation

by Jacqueline Belliveau

While accountable care organizations (ACOs) are popular and effective ways to implement value-based care, many ACOs are still facing significant challenges with managing risk and healthcare costs as the industry prepares for MACRA implementation....

Hospital Profitability Down for 27 Percent of PA Facilities

by Catherine Sampson

More than a quarter of acute care hospitals in Pennsylvania failed to achieve profitability in 2015, according to a recent report by the Pennsylvania HealthCare Cost Containment Council (PHC4). Twenty nine percent of the 170 hospitals in...

5 Ways to Increase Hospital Profitability, Aid Revenue Cycle

by Catherine Sampson

In this period of healthcare reform, numerous organizations continue to change their business practices so they can obtain more hospital profitability while also delivering quality care. Healthcare expenditures are expected to reach $4.4 trillion...

Patient Billing Challenges Revenue Cycle Management

by Catherine Sampson

Patient payment and billing are significant revenue cycle management challenges that should not be ignored.  According to a recent survey conducted by Navicure, 63 percent of participants recognized that patient payment processes were “a...

Nonprofit Organizations Lead Way in Hospital Revenue Cycle

by Catherine Sampson

Profits in hospital revenue cycles for nonprofit health organizations were strong in 2013. That year, seven of the top 10 most profitable hospitals in the US were nonprofit facilities, according to a recent Health Affairs study. Each of the top...

High Patient Experience Scores Boost Hospital Net Margins by 50%

by Catherine Sampson

Hospitals in the US that provided a “superior” patient experience gained net margins that were 50 percent higher, on average, than those that deliver an “average” customer experience, researchers from Accenture observed....

71% of Healthcare Execs Anticipate Revenue Cycle Growth in 2016

by Catherine Sampson

Healthcare revenue cycle managers are likely to have their hands full through the rest of 2016 as the industry sees increases in revenue, patient volume, and opportunities for mergers and acquisitions, according to a new report from CIT Group....

5 Most Common Hospital Revenue Cycle Management Challenges

by Catherine Sampson

Since the Affordable Care Act, the task of hospital revenue cycle management has changed significantly. Between ICD-10, MACRA, and accountable care, it has become a hospital’s best interest to have an effective revenue cycle management...

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 reimbursement...

41% of Providers, Payers Adopt Value-Based Care Reimbursement

by Vera Gruessner

With the push from private and commercial health payers along with federal agencies to adopt value-based care reimbursement strategies, many more healthcare providers seem to have begun contracting through pay-for-performance arrangements. A...

How to Scale Healthcare Bundled Payments throughout Hospitals

by Vera Gruessner

Healthcare bundled payments are a key strategy across the industry aimed at boosting patient health outcomes, improving the quality of care, and bringing reimbursement toward a value-based payment model. While the Centers for Medicare & Medicaid...

Direct Physical Therapy Access Could Reduce Healthcare Costs

by Vera Gruessner

When it comes to healthcare costs, the federal government, medical providers, and payers are attempting to reduce rising spending and adopt value-based care reimbursement.  A number of different strategies have been implemented including...

5 Ways Smaller Providers Maximize Revenue Cycle Management

by Jacqueline DiChiara

Revenue cycle management is about breaking through the cash flow ceiling and generating the greatest amount of net revenue possible. But issues of claims denials, coding compliance, where to intelligently cut cost corners, automation hiccups,...

AMA, CMS Lead Discussion on Evolving Healthcare Market Today

by Jacqueline DiChiara

The American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS) are pairing up to lead a discussion today about the ongoing state of the evolving healthcare market. The discussion will be held at 5PM (PT) at...


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