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

Healthcare Revenue Cycle

Group Purchasing Increases Healthcare Supply Chain Savings

by Jacqueline LaPointe

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...

Provider Profitability Drops Under Biosimilar Use Reimbursement

by Jacqueline LaPointe

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...

PCP Patient Attribution Aids Providers in Value-Based Contracts

by Jacqueline LaPointe

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...

Long Wait Times Jeopardize Value-Based Purchasing Revenue

by Jacqueline LaPointe

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...

Proactive Healthcare Charge Integrity Captures Missed Revenue

by Jacqueline LaPointe

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...

41% of Rural Hospitals Operating with Negative Margins

by Jacqueline LaPointe

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...

Targeting Healthcare Cost Cuts Slows Revenue Cycle Performance

by Jacqueline LaPointe

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...

Revenue Integrity Top Hospital, Health System Exec Priority

by Jacqueline LaPointe

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...

Implementing Value-Based Healthcare Revenue Cycle Management

by Jacqueline LaPointe

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...

Care Standardization Key to Healthcare Revenue Cycle Excellence

by Jacqueline LaPointe

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...

ACOs Restructure Healthcare Staffing for High-Risk Patients

by Jacqueline LaPointe

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...

96% of Healthcare Execs Report Rise in Inpatient Drug Spending

by Jacqueline LaPointe

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...

Optimizing RCM During Value-Based Reimbursement Transition

by Jacqueline LaPointe

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...

Provider Collaboratives Combat Healthcare Merger Pressures

by Jacqueline LaPointe

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...

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

by Jacqueline LaPointe

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...

Healthcare Employment Shifting to Hospital-Employed Providers

by Jacqueline LaPointe

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...

86% of Providers Saw Prior Authorization Requirements Increase

by Jacqueline LaPointe

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...

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

by Jacqueline LaPointe

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...

Only 40% of ED Providers Identified Accurate Healthcare Costs

by Jacqueline LaPointe

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...

Commitment Key to Successful Value-Based Reimbursement Adoption

by Jacqueline LaPointe

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...

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