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

Healthcare Revenue Cycle

Low-Cost, Low-Value Resource Use Drives $586M in Wasteful Spending

by Jacqueline LaPointe

Inexpensive low-value resource use resulted in over $586 million, or $9.09 per beneficiary per month, in unnecessary healthcare spending in Virginia, a new Health Affairs study showed. The total amount spent on low-cost, low-value...

Order History, Machine Ownership Leads to Low-Value Imaging

by Jacqueline LaPointe

Providers are more likely to order costly, low-value imaging services if they have a history of ordering the services, a high rate of imaging in another low-value clinical situation, and an ownership stake in the imaging equipment,...

Healthcare Workforce Demand Growing Faster than Provider Supply

by Jacqueline LaPointe

The demands of the healthcare workforce are significantly outpacing the supply of new doctors available, especially for primary care providers, a recent Merritt Hawkins survey uncovered. The survey of 935 physicians in their final year of...

Health Systems Responsible for 70% of Acute Care Hospitals

by Jacqueline LaPointe

New data from the Agency for Healthcare Research and Quality (AHRQ) showed that most hospitals were part of a health system in 2016. Almost 70 percent of non-federal generate acute care hospitals belonged to a health system, or network of...

Healthcare RCM Vendors ZirMed and Navicure Announce Merger

by Jacqueline LaPointe

Healthcare revenue cycle management vendors Navicure and ZirMed recently announced that the organizations signed a definitive agreement to merge. Navicure will supposedly acquire ZirMed in a deal that values at about $750 million, sources...

Over 50% of Orgs Lack Adequate Healthcare Cost Reduction Goals

by Jacqueline LaPointe

An overwhelming majority of healthcare executives (96 percent) stated that cost transformation is a significant need for their hospital or health system. Yet, over one-half of organizations either do not have a healthcare cost reduction...

Revenue Cycle Management, Upgrades Jump to Top Hospital Priority

by Jacqueline LaPointe

Hospitals leaders are pushing revenue cycle management to the top of their priority lists in the last quarter of 2017, a recent Black Book Market Research survey uncovered. Almost three-quarters of struggling hospitals are prioritizing...

Federally Qualified Health Centers Troubled By Rising Competition

by Jacqueline LaPointe

About 61 percent of leaders at federally qualified health centers (FQHCs) anticipate competition to rise in the next year, threatening their revenue cycle and financial stability, a recent Sage Growth Partners (SGP) survey revealed. The...

Small Transactions Drive Healthcare Mergers and Acquisitions

by Jacqueline LaPointe

About one-half of the growth of medical groups that originally employed over 100 physicians between 2007 and 2013 involved healthcare mergers and acquisitions with groups of ten or fewer physicians, a recent Health Affairs study...

Key Strategies for Health Systems to Achieve Economies of Scale

by Jacqueline LaPointe

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...

Exploring Key Components of the Healthcare Revenue Cycle

by Jacqueline LaPointe

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...

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

by Jacqueline LaPointe

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...

Small Health System Achieves ROI with Asthma Management Clinic

by Jacqueline LaPointe

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...

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

by Jacqueline LaPointe

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...

Medicare Reimbursement Add-On to Boost Palliative Care Revenue

by Jacqueline LaPointe

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...

Skilled Nursing Facilities See $370M Medicare Reimbursement Bump

by Jacqueline LaPointe

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...

Volume, Value of Healthcare Merger and Acquisition Deals Up

by Jacqueline LaPointe

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...

Healthcare Revenue Cycle Software Market to Grow at 4.5% CAGR

by Jacqueline LaPointe

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...

Free Health Clinics Face ROI, Clinical Efficiency Obstacles

by Jacqueline LaPointe

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...

Geisinger Lowers Turnover for Healthcare Revenue Cycle Success

by Jacqueline LaPointe

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...

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