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

Hospital Revenue Cycle

Top 4 Rural Hospital Challenges with Revenue Cycle Management

by Jacqueline LaPointe

Rural hospitals may be the only healthcare option for individuals living in sparsely populated areas, but revenue cycle management challenges have forced many of these facilities to permanently close their doors. The healthcare industry...

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...

Breaking Down the Top 5 Healthcare Revenue Cycle KPIs

by Jacqueline LaPointe

With value-based reimbursement and healthcare consumerism taking hold of the industry, provider organizations are under pressure to ensure their healthcare revenue cycle is operating at maximum efficiency. To effectively track healthcare...

Is a Chief Primary Care Officer Key to Value-Based Purchasing?

by Jacqueline LaPointe

Developing a Chief Primary Care Medical Officer role should help health systems achieve value-based purchasing success by focusing on establishing care coordination systems and improving key quality measures, argued industry experts in a...

Beth Israel, Lahey Health Ink Final Healthcare Merger Agreement

by Jacqueline LaPointe

Boston-based Beth Israel Deaconess health system and Lahey Health recently finalized a healthcare merger agreement after about seven months of negotiations. Despite several failed attempts at a healthcare merger in the past, the two...

Small Hospitals, Systems Grapple with Value-Based Reimbursement

by Jacqueline LaPointe

Approximately 67 percent of small hospitals and health systems do not plan on undertaking value-based reimbursement initiatives in 2017, a recent Ernst & Young LLP Advisory Health survey revealed. The survey of 700 healthcare...

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...

GAO: Hospital Value-Based Purchasing Model Rewards Low Quality

by Jacqueline LaPointe

A new Government Accountability Office (GAO) report found that CMS gave financial bonuses to hospitals participating in the Hospital Value-Based Purchasing Program despite the facilities earning composite quality scores below the...

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...

68% of Consumers Did Not Pay Patient Financial Responsibility

by Jacqueline LaPointe

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...

Hospital Execs Look to Operations to Control Healthcare Costs

by Jacqueline LaPointe

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...

AHA to IRS: Foster Hospital Participation in Commercial ACOs

by Jacqueline LaPointe

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)...

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...

3 Best Practices for Hospital Claim Denials Management

by Jacqueline LaPointe

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...

NYC Hospital Adds Epic Revenue Cycle Management to EHR System

by Jacqueline LaPointe

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...

High-Cost Patients Widely Distributed Across Hospitals, Markets

by Jacqueline LaPointe

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...

Is Billing Some Patients at Hospital Chargemaster Rates Legal?

by Jacqueline LaPointe

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...

Brigham and Women’s Offers Buyouts to Lower Healthcare Costs

by Jacqueline LaPointe

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...

Key Ways to Start A Hospital Revenue Cycle Turnaround Process

by Jacqueline LaPointe

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...

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