Interviews

What’s Behind Private Equity’s Interest in RCM Vendors

March 5, 2024 - A major offer from a private equity firm is making waves in the revenue cycle management (RCM) vendor space, showcasing private equity’s interest in RCM vendors and software. New Mountain Capital, a private equity and capital firm headquartered in New York, recently offered to buy all of R1 RCM’s outstanding shares not currently owned by investors. The firm, which already...


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How Can Providers Establish Successful Accountable Care Organizations?

by Victoria Bailey

Accountable care organizations (ACOs) are a common way healthcare providers can transition from fee-for-service to value-based care delivery. In ACOs, providers come together to deliver quality coordinated care to patients while usually...

From Pilot to Scale, Mount Sinai Leverages Autonomous Medical Coding

by Jacqueline LaPointe

An experiment to streamline medical coding is set to take off at Mount Sinai Health System. The academic medical system nestled in the New York metropolitan area recently implemented autonomous medical coding within its pathology...

Top Trends in Automation, AI Adoption in Revenue Cycle

by Jacqueline LaPointe

Automation has a lot of potential to streamline revenue cycle management, and healthcare organizations are certainly interested in adopting technology to achieve efficiency. However, that interest is not necessarily turning into investment...

Overcoming the Barriers to Value-Based Payment in Primary Care

by Victoria Bailey

Primary care is arguably the most critical component of our healthcare system. Primary care and preventive medicine can help avert and manage chronic diseases and prevent long-term complications. However, efforts to improve primary care...

How AI is Becoming a Staple in Medical Coding, Auditing

by Jacqueline LaPointe

Troves of data flow through the healthcare revenue cycle. Yet, many providers struggle to make sense of the codes and clinical documentation to not only submit clean claims but also understand patient encounters that occur within their...

How to Adapt as Healthcare Workforce Management Shifts

by Jacqueline LaPointe

There’s a significant workforce crisis in healthcare right now, according to Sarah Nosal, MD, FAAFP, a family physician and a member of the board of directors at the American Academy of Family Physicians (AAFP). Nosal, who also...

How a GoFundMe Page Aims to Keep a Rural Hospital Open

by Jacqueline LaPointe

When financial troubles turned dire, leaders of a rural hospital turned to a popular source of funding to support their efforts to get back on their feet: GoFundMe. Crowdfunding platforms like GoFundMe are popular among individuals...

Key Considerations For Choosing a Revenue Cycle Technology Vendor

by Jacqueline LaPointe

Revenue cycle technology is not one size fits all. Whether a solution promises to ease patient collection woes or streamline claims management processes, healthcare providers must do their due diligence to select the revenue cycle...

How Nursing Homes Can Prepare for Staffing Standards, Gaps

by Victoria Bailey

After experiencing the brunt of the COVID-19 pandemic, long-term care facilities have prioritized strategies to improve staffing levels and care quality. The federal government has taken action, too, proposing minimum staffing standards...

Overcoming the Barriers to AI Adoption in Revenue Cycle Management

by Jacqueline LaPointe

About a third of hospital financial leaders have never used automation in revenue cycle operations. Nearly two-thirds of hospitals haven’t automated any part of claims denial management. And approximately a third of prior...

Value-Based Reimbursement Grows as Providers Take on More Risk

by Jacqueline LaPointe

Over half of healthcare payments last year were made through value-based reimbursement models, with most of those payments tied to some degree of financial risk, according to the latest data from the Health Care Payment & Learning...

Generative AI’s Potential Shines on Revenue Cycle Management

by Jacqueline LaPointe

Healthcare has its eyes on generative artificial intelligence (AI). The technology, including the popular ChatGPT tool, has passed medical exams, diagnosed complex cases, and designed new ways to combat COVID-19. However, its most...

Unlocking the Future of Value-Based Care With Data

by Jacqueline LaPointe

Advocate Health is a value-based care leader. More than 2.4 million lives are covered by the health system’s value-based care contracts, which include 12 different accountable care organizations (ACOs) and clinically integrated...

How Vermont’s All-Payer ACO Model Paves the Way for Value-Based Care

by Victoria Bailey

As its name states, the Vermont All-Payer Accountable Care Organization (ACO) Model is an arrangement that incorporates patients with both private and public healthcare coverage, but what makes this model so appealing to providers? Is this...

What the Latest Court Decisions Mean for the Federal IDR Process

by Jacqueline LaPointe

The latest court rulings in a series of legal challenges have left the No Surprises Act’s (NSA’s) federal independent dispute resolution (IDR) process in limbo yet again. In an announcement on the CMS website on August 25th,...

Private Equity Acquisitions Come with Growing Antitrust Concerns

by Victoria Bailey

In some instances, private equity acquisitions have pro-competitive benefits for physician practices, Diane Hazel, partner at Foley & Lardner, told RevCycleIntelligence. Private equity firms can help practices consolidate operations,...

Healthcare’s Interest in Private Credit, Other Funding Sources Grows

by Jacqueline LaPointe

There has been a lot of buzz around private equity's growing reach in healthcare, but providers have other options to fund growth. And one of those funding sources is gaining popularity. "Private credit is filling a void right now,"...

As Patient Financial Responsibility Grows, Technology Key to Collections

by Jacqueline LaPointe

You may not want to think about the new year just yet. But if you don’t have a patient payment solution in place now, you might be sorry come January. Patient financial responsibility has hit all-time highs over the last decade,...

Private Equity in Healthcare Is Under A Microscope, So What’s Next?

by Jacqueline LaPointe

Private equity is gaining a foothold in healthcare despite growing evidence that its role has been detrimental to care quality and prices. But new data and even governmental concern aren't slowing private equity investments in provider...