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

Hospital Revenue Cycle

68% of Consumers Did Not Pay Patient Financial Responsibility

June 27, 2017 - About 68 percent of patients with medical bills of $500 or less did not fully pay their patient financial responsibility to hospitals in 2016, according to a recent TransUnion Health study. The proportion of individuals failing to pay off full medical bill balances increased from 53 percent in 2015 and 49 percent in 2014. “There are many reasons why more patients are struggling to make...

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Hospital Execs Look to Operations to Control Healthcare Costs

by Jacqueline Belliveau

With 78 percent of hospital leaders stating that rising healthcare costs are their primary concern in 2017, the leaders agreed that reviewing and optimizing existing operational and clinical processes was the hospital’s top strategy for...

AHA to IRS: Foster Hospital Participation in Commercial ACOs

by Jacqueline Belliveau

The American Hospital Association (AHA) recently called on leaders from the Department of Treasury and IRS to issue formal guidance that would permit non-profit hospitals to participate in commercial accountable care organizations (ACOs) without...

Healthcare Employment Shifting to Hospital-Employed Providers

by Jacqueline Belliveau

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 ownership...

3 Best Practices for Hospital Claim Denials Management

by Jacqueline Belliveau

Healthcare cost control continued to top hospital priority lists in 2017. But hospital leaders may be leaving millions of dollars on the table because of inefficient claim denials management processes. Claim denial rates ranged between 0.54 percent...

NYC Hospital Adds Epic Revenue Cycle Management to EHR System

by Jacqueline Belliveau

NYC Health and Hospitals Corporation (NYCHHC) recently selected to implement an Epic healthcare revenue cycle management solution to help the health system boost adjusted patient revenue by another 5 percent. The largest public health system...

High-Cost Patients Widely Distributed Across Hospitals, Markets

by Jacqueline Belliveau

A recent American Journal of Managed Care study attempting to understand why some patients incur higher healthcare costs than others found that high-cost patients were evenly spread across providers and healthcare markets. Using a 20 percent...

Is Billing Some Patients at Hospital Chargemaster Rates Legal?

by Jacqueline Belliveau

Contract law does not uphold the medical billing practice of charging uninsured or out-of-network insured patients hospital chargemaster rates that are not based on actual healthcare costs or market-negotiated prices, argued authors of a recent...

Brigham and Women’s Offers Buyouts to Lower Healthcare Costs

by Jacqueline Belliveau

Boston-based Brigham and Women’s Hospital recently presented 1,600 employees with a voluntary buyout option in an effort to control the facility’s healthcare costs, a local news source reported. Hospital officials reassured reporters...

Key Ways to Start A Hospital Revenue Cycle Turnaround Process

by Jacqueline Belliveau

Healthcare executives often point to market factors for lackluster hospital revenue cycle performance. But lagging accounts receivable days and shrinking hospital margins usually indicate that it is time for an internal hospital revenue cycle...

Prescription Drug Rates Remain Top Healthcare Supply Chain Issue

by Jacqueline Belliveau

Almost all health system executives (99 percent) in a recent Premier survey agreed that rising prescription drug rates continue to plague their healthcare supply chain. The winter 2017 survey of 91 C-suite executives at health systems also uncovered...

Value-Based Reimbursement Spurs 8% Hospital Merger Growth

by Jacqueline Belliveau

Value-based reimbursement trends drove health system and hospital merger activity to increase 8 percent compared to the first quarter of 2016, Anu Singh, a Managing Director at Kaufman, Hall & Associates, recently told

Hospitals Maintain Test Use Despite Healthcare Price Transparency

by Jacqueline Belliveau

Increasing healthcare price transparency for providers did not result in fewer laboratory tests ordered or lower healthcare costs, a recent JAMA Internal Medicine study found. “In this year-long randomized clinical trial conducted at three...

How Adding Physician Assistants Improves Hospital Revenue Cycle

by Jacqueline Belliveau

Physician assistants are key players on hospital care teams, but leveraging staffing levels and care delivery capabilities may improve hospital revenue cycle. Many hospital leaders and physicians face greater care delivery, administrative, and...

CMS Calls On Rural Hospitals to Join Alternative Payment Model

by Jacqueline Belliveau

CMS is seeking applicants to participate in a new round of the Rural Community Hospital Demonstration Program that tests a cost-based alternative payment model among small rural hospitals. Lawmakers authorized a five-year extension of the demonstration...

Boost Healthcare Competition to Drive Down Prices, Up Quality

by Jacqueline Belliveau

The lack of healthcare competition stemming from recent healthcare merger and acquisition trends resulted in higher prices and lower care quality, industry experts recently argued in a Carnegie Mellon University’s Heinz College white paper....

AHA: Uncompensated Care Costs Worksheet Inaccurate, Inconsistent

by Jacqueline Belliveau

The American Hospital Association (AHA) recently called on CMS to audit and modify the hospital cost report, Worksheet S-10, before the federal agency uses the report to determine each hospital’s uncompensated care costs and supplemental...

Medicaid Expansion Linked to $5M Annual Hospital Revenue Boost

by Jacqueline Belliveau

Hospital revenue in Medicaid expansion states increased by $5 million annually per facility after states chose to extend Medicaid coverage to more individuals, a recent Robert Wood Johnson Foundation and Urban Institute report showed. The study...

IL Supreme Court Maintains Non-Profit Hospital Tax Exemption

by Jacqueline Belliveau

The Illinois Supreme Court recently legally voided an appellate court’s decision that non-profit hospital tax exemption was unconstitutional. In Illinois, non-profit hospitals qualify for property tax exemption if the value of all charitable...

NJ Quality Improvement Model Lowers Healthcare Costs by $641M

by Jacqueline Belliveau

Hospitals in New Jersey reduced healthcare costs by over $641 million between 2012 and 2016 after implementing a statewide quality improvement initiative, the New Jersey Hospital Association (NJHA) recently reported. Under the Affordable Care...


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