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

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NY Group Rethinks Physician Consolidation to Add Long-Term Value

March 18, 2019 - Physician consolidation, value-based care, and other market pressures are sounding the death knell for many small and independent practices. Less than a third of physicians owned an independent practice in 2018, according to a Physicians Foundation and Merritt Hawkins survey. Instead, almost half of the surveyed physicians said they closed shop and/or started working for a hospital or...


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How Practices Can Benefit from Healthcare Price Transparency

by Jacqueline LaPointe

In 2019, CMS mandated all hospitals in the US to publish a list of their standard charges online. The federal agency intends for healthcare price transparency to empower patients to make more cost-conscious decisions when it comes to their...

Rethinking the Claims Clearinghouse Relationship Helps Hospitals

by Jacqueline LaPointe

A growing network of post-acute care hospitals based in Pennsylvania recently achieved a near perfect clean claims rate and uncovered $12 million in inappropriate payer denials after switching its claims clearinghouse vendor. Vibra...

Bots Make Claim Status Inquiry More Efficient for Avera Health

by Jacqueline LaPointe

Robots in healthcare do not have to be large human-like machines that replace providers. But bots embedded in software applications can be a key tool for reducing the burden of mundane, common tasks, such as claim status inquiry. At least...

Post-Acute, At-Home Care Saves Next Gen ACO Atrius Health $19.9M

by Jacqueline LaPointe

“You can't emphasize enough the right setting and the right care,” stressed Peggy Chou, MD, the Senior Medical Director of Performance Excellence of Atrius Health in Massachusetts. Atrius Health is a non-profit system of...

Major Health Systems Create New Company to Tackle Drug Shortages

by Jacqueline LaPointe

Drug shortages are preventing hospitals from providing even the most basic care to patients. In a recent study by the National Opinion Research Center (NORC) at the University of Chicago, approximately 80 percent of hospitals found it...

Small Hospital Boosts Bottom Line Through Patient Access Automation

by Jacqueline LaPointe

“The patient access area is where everything starts, and that mindset is what led to our success.” That was the sentiment of Deonne Henry, the Vice President of Revenue Cycle at Magnolia Regional Health Center in Mississippi....

Social Determinants of Health Key to Value-Based Purchasing Success

by Jacqueline LaPointe

We are quickly heading to the value-based purchasing tipping point, according to the Vice President of Network Management at Health Partners Plans in Pennsylvania. “While adoption rates are still relatively low in some regions of...

Accounting for the Patient in the Healthcare Revenue Cycle

by Jacqueline LaPointe

From value-based care to record-high levels of patient financial responsibility, the healthcare industry is undergoing a tremendous amount of evolution. And the healthcare revenue cycle is having to learn some new tricks to keep up. Top...

Investing in Primary Care Delivers Value-Based Care Results

by Jacqueline LaPointe

Supporting primary care will bring value-based care results, asserts Humana’s Chief Medical Officer Roy Beveridge, MD. Value-based arrangements between providers and payers have the lofty, yet admirable goals of improving care...

Aligning the Healthcare Revenue Cycle with Patient Experience

by Jacqueline LaPointe

Improving a patient’s financial experience is key to healthcare revenue cycle management success, according to the Senior Regional Director of Revenue Cycle at Ascension Healthcare. “Moving into the future, we need to focus...

Looking Beyond Price in the Healthcare Supply Chain to Add Value

by Jacqueline LaPointe

Don’t equate value in the healthcare supply chain with just price, Premier, Inc’s Myla Maloney recently advised healthcare stakeholders at Xtelligent Healthcare Media’s Value-Based Care Summit in Boston. “Price...

Putting Both Feet in the Value-Based Care, Reimbursement Boat

by Jacqueline LaPointe

“Do not put each foot in a different boat,” warned Partners HealthCare CFO Peter Markell at Xtelligent Healthcare Media’s third annual Value-Based Care Summit in Boston. But the current reality in healthcare is that...

4 Hospital Business Models for Consumer-Centric Healthcare

by Jacqueline LaPointe

When a member of Gurpreet Singh’s family broke his wrist, they didn’t go to a hospital emergency room or an academic medical. Instead, the family headed to an urgent care center to triage the situation and develop a care...

Aligning Incentives for Providers, Payers Improves Primary Care

by Jacqueline LaPointe

How the healthcare industry delivers and pays for primary care is changing as the country finds their healthcare spending skyrocketing. Healthcare spending across the country is slated to increase at an average annual rate of 5.5 percent...

End-to-End Revenue Cycle Management Key to Success at Ascension

by Jacqueline LaPointe

The healthcare revenue cycle contains many moving parts. Hospitals and health systems typically rely on a patchwork of technologies and best practices to ensure everything from patient access and registration to medical billing and...

New Alternative Payment Model Tackles Holistic Addiction Recovery

by Jacqueline LaPointe

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...

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...

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