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

Hospital Revenue Cycle

State Green Lights Partners, Mass. Eye and Ear Hospital Merger

February 20, 2018 - Massachusetts public health officials recently approved a proposed hospital merger between the state’s largest hospital system, Partners HealthCare, and specialty hospital Massachusetts Eye and Ear. The Public Health Council unanimously voted to allow the hospital merger deal after an extensive public debate over whether a Partners and Mass Eye and Ear merger would increase healthcare...


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Addressing Regulatory Burden, Patient Payments Top HIMSS18 Trends

by Jacqueline Belliveau

Healthcare finance professionals can bet on discussing compliance, innovative health IT systems, and patient financial responsibility at the 2018 HIMSS Annual Conference and Exhibition (HIMSS18) in Las Vegas. Over 45,000 healthcare stakeholders...

Financial Challenges Continue to Trouble Community Hospital CEOs

by Jacqueline Belliveau

Financial challenges continued to keep community hospital CEOs up at night in 2017, according to a recent American College of Healthcare Executives (ACHE) survey. Once again, hospital leaders identified financial obstacles as the top issue their...

Flexibility, Value-Based Payment Key to Rural Hospital Success

by Jacqueline Belliveau

Health policies should provide rural hospitals with the flexibility to develop healthcare services that meet community needs and the value-based payment and funding structures to support tailored services, the Bipartisan Policy Center (BPC) and...

Health Systems Form Drug Company to Combat Rising Costs, Shortages

by Jacqueline Belliveau

Intermountain Healthcare, Ascension, SSM Health, and Trinity Health recently announced that they will create a non-profit generic drug company to reduce prescription costs and alleviate critical drug shortages. With consulting services with the...

Hospital Closures Increased in States Without Medicaid Expansion

by Jacqueline Belliveau

Hospitals in Medicaid expansion states were six times, or about 84 percent, less likely to face hospital closures than their peers in non-expansion states, a new Health Affairs study showed. The hospital closure rate decreased by 0.33 per 100...

3 Strategies to Reduce Hospital Readmission Rates, Costs

by Jacqueline Belliveau

Providers understand that high hospital readmission rates spell trouble for patient outcomes. But excessive rates may also threaten a hospital's financial health, especially in a value-based reimbursement environment. Readmissions are...

6 Major Hospital Merger Deals Making Headlines in 2018

by Jacqueline Belliveau

In 2017, the healthcare industry saw a boom of hospital merger announcements. And many of those deals are set to close in 2018 pending federal and state regulatory review. Hospital merger and acquisition activity last year was well on its way...

4 Key Ways to Improve Healthcare Revenue Cycle Management

by Jacqueline Belliveau

“There is always room for improvement” should be healthcare revenue cycle management’s mantra. Declining claims reimbursement rates, the shift to value-based purchasing, and evolving health policies keep revenue cycle leaders...

Top 10 ICU Diagnoses Driving Up Healthcare Costs, Care Variations

by Jacqueline Belliveau

Cardiac procedures and sepsis dominated the list of top ten intensive care unit (ICU) diagnoses that represented the greatest opportunity for hospitals to reduce healthcare costs and care variations for ICU length of stay, a recent Premier Inc....

Advocate, Aurora and Dignity Health, CHI Sign Hospital Merger Deals

by Jacqueline Belliveau

The healthcare market in Chicago is bracing for some major changes starting with the recently announced hospital merger between Advocate Health Care and Wisconsin-based Aurora Health Care. The largest health system in Illinois revealed its intentions...

ED Spending Increases 85% As Hospitals Code for More Severe Cases

by Jacqueline Belliveau

Emergency department spending per member rose 85 percent between 2009 and 2015 primarily because of hospitals coding and billing for a greater number of high severity cases, new Health Care Cost Institute (HCCI) data revealed. Spending on high...

Private Payer A/R, Denials Performance Troubles Hospital Revenue

by Jacqueline Belliveau

Small differences in private payer performance on claims reimbursement and denials can challenge hospital revenue cycles, a new Crowe Horwath analysis of five major commercial managed care payers uncovered. “Many providers focus their attention...

Value-Based Contracts Rely on Patient Attribution, Data Sharing

by Jacqueline Belliveau

CMS aims to tie 90 percent of Medicare fee-for-service payments to quality by the end of 2018, with one-half of those payments to be paid under a value-based contract with some degree of financial risk. With ambitious goals from the federal government,...

Hospitals Write Off 90% More Claim Denials, Costing up to $3.5M

by Jacqueline Belliveau

Hospitals strengthened key revenue cycle components over the past two years, but claims denials represented a major threat to their financial health, the recent Revenue Cycle Survey from Advisory Board revealed. Health systems and hospitals wrote...

Pay-for-Performance Models Hurt Safety-Net Hospital Finances

by Jacqueline Belliveau

Medicare pay-for-performance models may disproportionately penalize safety-net hospitals and other organizations that serve the most vulnerable patient populations, a new study in Medical Care found. Hospitals in one of the most socioeconomically...

Trevor Fetter Steps Down as Tenet Healthcare Corp CEO, Director

by Jacqueline Belliveau

Tenet Healthcare Corporation CEO Trevor Fetter stepped down earlier than expected as head of the health system. He also resigned as director of the company, Tenet recently announced. The health system stated in August 2017 that Fetter would no...

2017 Hospital Merger Activity Likely to Beat 102 Deals in 2016

by Jacqueline Belliveau

Healthcare organizations engaged in 87 hospital merger and partnership transaction so far in 2017, a recent Kaufman Hall analysis showed. The most recent data revealed that 29 hospital merger and partnership deals were announced in the third...

Hospital Mergers Take Two or More Years to Produce Cost Savings

by Jacqueline Belliveau

Hospital mergers and acquisitions resulted in immediate decreases in operating expenses per adjusted admission. However, acquired facilities also saw operating revenue decline at a higher rate, leading to falling operating margins for the first...

Tenet Starts Chicago Market Exit with Sale of MacNeal Hospital

by Jacqueline Belliveau

Tenet Healthcare Corporation recently announced that Loyola Medicine has signed a definitive agreement to purchase MacNeal Hospital, one of Tenet’s four hospitals in the Chicago area. Loyola Medicine, an affiliate of Trinity Health, will...

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