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

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New Alternative Payment Model Tackles Holistic Addiction Recovery

September 12, 2018 - A national multi-sector alliance of healthcare industry leaders is looking to incentivize providers and payers to deliver coordinated, holistic addiction recovery services to patients through a new alternative payment model. Nearly 21 million people have a substance abuse disorder. Yet only one out of ten individuals receive treatment, according to data from the Surgeon General. To...


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RCCH Uses Predictive Analytics to Boost Claim Denials Management

by Jacqueline LaPointe

Predictive analytics are key to implementing an effective and efficient claim denials management strategy that tackles the right denials at the right time, according to the Vice President of Revenue Cycle at Tennessee’s RCCH...

Artificial Intelligence Ensures Payer, Provider Pay Covers Costs

by Jacqueline LaPointe

Artificial intelligence (AI) in healthcare is influencing the next generation of radiology tools and helping to expand access to care in underserved or developing areas. The technology is supporting clinical advancements, but a...

Using Text Messages to Improve Healthcare Recruitment, Employment

by Jacqueline LaPointe

Getting qualified healthcare professionals in the door for interviews as quickly as possible is paramount for provider organizations facing a competitive healthcare recruitment and employment market. The healthcare industry is in the...

Paperless Medical Billing Key to Boosting Patient Collections

by Jacqueline LaPointe

In the age of smartphones, tablets, and other technologies that put information literally in the palm of our hands, why do doctors still rely on paper to reach their patients for medical billing purposes? That was the question Max...

Revenue Cycle Management Integration Boosts the Bottom Line

by Jacqueline LaPointe

When you ask a provider which EHR system he uses, you expect to hear a single vendor, such as Epic, Cerner, or MEDITECH. But when you inquire about a provider’s revenue cycle management system, you are likely to get a laundry list of...

How Hospitals Bring in Revenue Through the Healthcare Supply Chain

by Jacqueline LaPointe

The healthcare supply chain is a cost center for provider organizations of all sizes. Through the supply chain, healthcare organizations spend money on the items and supplies they need to deliver the services that bring in revenue. As a...

WA Makes Healthcare Price Transparency Consumer-Friendly

by Jacqueline LaPointe

How much does a knee replacement surgery cost at MultiCare Auburn Medical Center in Auburn, Washington versus St. Anthony Hospital in nearby Gig Harbor? Does EvergreenHealth Medical Center in Kirkland deliver the highest value birthing...

Quantifying Financial Distress to Stop Hospital Bankruptcy, Closure

by Jacqueline LaPointe

More healthcare organizations will face financial troubles, and possibly a hospital bankruptcy or closure, in the coming years as the healthcare industry undergoes major changes. Changes that will result in lower reimbursement rates, more...

When Should Providers Consider a Strategic Hospital Acquisition?

by Jacqueline LaPointe

For many small hospitals, remaining independent as the healthcare industry hurdles toward value-based purchasing, population health management, and other transformations is a source of pride even if the organization has one foot in the...

Finding a Revenue Cycle Management System for Post-Acute Care

by Jacqueline LaPointe

Post-acute care has become a major focus as providers, payers, and policymakers attempt to cut healthcare costs and improve long-term patient outcomes. However, the revenue cycle management space is dragging its feet when it comes to...

A Provider-Sponsored Health Plan Is A Hospital’s Natural Next Step

by Jacqueline LaPointe

Many hospitals and health systems are bypassing the ultimate opportunity to gain greater control of the outcomes and costs of their patients. That opportunity is developing their own provider-sponsored health plan, according to Geisinger...

Providers Investing in Home Health to Prepare for Aging Population

by Jacqueline LaPointe

Faced with the pressure to reduce healthcare costs as the elderly population rapidly grows, providers plan to shift elder care from hospitals and skilled nursing facilities to the home, healthcare experts explained. According to CMS and...

Quality Improvement Projects Save Children’s Hospitals Millions

by Jacqueline LaPointe

Care quality improvements require hospitals to invest their money, time, and staff. The investment may be large, but for two children’s hospitals it paid off, saving the organizations millions and reducing costly accidents and...

Healthcare Mergers, Increased Access to Boost Medical Costs 6%

by Jacqueline LaPointe

PwC’s Health Research Institute (HRI) predicts medical costs for employers to grow 6 percent in 2019 as healthcare mergers and more convenient care access options drive up healthcare costs and utilization. The medical cost trend is...

Automated Physician Queries Improve Clinical Documentation at WMHS

by Jacqueline LaPointe

Accurate claims reimbursement hinges on complete clinical documentation, and therefore, quick responses to physician queries regarding medical record documentation and coding. This is especially true in Maryland’s unique hospital...

Giving GA Hospitals Healthcare Cost Data to Lowering Spending

by Jacqueline LaPointe

With claims reimbursement rates falling and competition among healthcare organizations intensifying, hospitals are calling on their providers to increase efficiency and reduce healthcare costs for each admission. So, what do providers...

Payment Plans Key to Collecting Patient Financial Responsibility

by Jacqueline LaPointe

With the rise in popularity of high deductible health plans, hospitals are no longer waiting on just payers to collect what is owed to their hospital or practice. Patients have become a major revenue source, but hospitals are struggling to...

Addressing Productivity, Labor to Bend the Healthcare Cost Curve

by Jacqueline LaPointe

From alternative payment models and value-based purchasing to artificial intelligence and data analytics tools, the healthcare industry is transforming how care is delivered and paid for to reduce constantly rising medical costs. While...

“Just the Beginning” of Healthcare Price Transparency, Verma Says

by Jacqueline LaPointe

Requiring hospitals to post a list of their standard charges online is just the beginning of the push for increased healthcare price transparency by CMS, explained the federal agency’s Administrator Seema Verma. “As people are...

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