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

Healthcare Revenue Cycle

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...

Targeting Healthcare Cost Cuts Slows Revenue Cycle Performance

by Jacqueline Belliveau

Health system and hospital revenue cycle fell behind in key performance areas, such as claim denials management and bad debt, because the organizations prioritized healthcare cost reductions over revenue cycle performance, a recent Advisory Board...

Revenue Integrity Top Hospital, Health System Exec Priority

by Jacqueline Belliveau

Hospital and health system leaders plan to prioritize revenue integrity in the next year to improve their healthcare revenue cycle management strategies, according to a recent Healthcare Financial Management Association (HFMA) and Navigant survey....

Implementing Value-Based Healthcare Revenue Cycle Management

by Jacqueline Belliveau

To align healthcare revenue cycle with value-based reimbursement, healthcare organizations should start by breaking down clinical and financial siloes established by fee-for-service payment models, agreed presenters at Xtelligent Media’s...

Care Standardization Key to Healthcare Revenue Cycle Excellence

by Jacqueline Belliveau

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...

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...

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