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

Revenue Cycle Management

Exploring Key Components of the Healthcare Revenue Cycle

August 21, 2017 - The healthcare revenue cycle encompasses “all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue,” according to the Healthcare Financial Management Association (HFMA). But the cycle traditionally contains distinct areas that oftentimes function separately from each other. A traditional healthcare revenue cycle...


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Top 10 Enterprise Resource Planning (ERP) Vendors By Hospital Use

by Jacqueline Belliveau

Healthcare providers have become increasingly interested in implementing enterprise resource planning (ERP) systems as part of their business intelligence and revenue cycle management suites. ERP systems are business management tools that give...

Top 4 Rural Hospital Challenges with Revenue Cycle Management

by Jacqueline Belliveau

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 has seen...

Volume, Value of Healthcare Merger and Acquisition Deals Up

by Jacqueline Belliveau

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 transactions...

Healthcare Revenue Cycle Software Market to Grow at 4.5% CAGR

by Jacqueline Belliveau

The healthcare revenue cycle management software market is slated to grow at a modest compound growth rate (CAGR) of 4.5 percent between 2017 and 2021, stated a recent Research and Markets report. “The latest trend gaining momentum in the...

Breaking Down the Top 5 Healthcare Revenue Cycle KPIs

by Jacqueline Belliveau

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 revenue...

Free Health Clinics Face ROI, Clinical Efficiency Obstacles

by Jacqueline Belliveau

Free health clinics help uninsured and low-income individuals access affordable care, but two recent studies show that free clinics may face healthcare costs and clinical efficiency challenges. New research in the Journal of the American Board...

Geisinger Lowers Turnover for Healthcare Revenue Cycle Success

by Jacqueline Belliveau

A MAP Award for High Performance in Revenue Cycle from the Healthcare Financial Management Association (HFMA) indicates that a health system achieved outstanding healthcare revenue cycle performance on metrics such as net days in accounts receivable...

Making a Business Case for the Patient-Centered Medical Home

by Jacqueline Belliveau

Transforming primary care practices to patient-centered medical homes (PCMHs) and maintaining National Committee for Quality Assurance (NCQA) recognition cost a large physician network about $2.5 million, or $43,000 per practice, revealed a new...

Greater Non-Physician Staffing Helps Healthcare Revenue Cycle

by Jacqueline Belliveau

Increasing the number of non-physician providers and support staff, such as physician assistants and nurse practitioners, is key to healthcare revenue cycle performance, a recent MGMA survey revealed. The survey of over 2,900 medical groups across...

GAO Identifies VA Provider Productivity Measure Shortcomings

by Jacqueline Belliveau

The VA lacks appropriate provider productivity measures and clinical efficiency models to accurately capture medical center performance, the Government Accountability Office (GAO) recently reported. A review of the VA Central Office and six VA...

Designing Care Models to Treat High-Need, High-Cost Patients

by Jacqueline Belliveau

A recent report from the National Academy of Medicine (NAM) explored how healthcare organizations can identify high-need, high-cost patients and implement care models that appropriately address the needs of the population to reduce healthcare...

Group Purchasing Increases Healthcare Supply Chain Savings

by Jacqueline Belliveau

Group purchasing organizations (GPOs) increased healthcare supply chain savings between 10 percent and 18 percent by reducing transaction costs and supplier prices, a recent Healthcare Supply Chain Association (HSCA) study revealed. The literature...

Provider Profitability Drops Under Biosimilar Use Reimbursement

by Jacqueline Belliveau

Biosimilar use could be the key to lowering healthcare costs associated with biologic treatments, but provider profitability may suffer by as much as $100 million across care settings if providers continue to administer the low-cost alternative,...

41% of Rural Hospitals Operating with Negative Margins

by Jacqueline Belliveau

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 states...

Targeting Healthcare Cost Cuts Slows Revenue Cycle Performance

by Jacqueline Belliveau

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 Advisory Board...

Revenue Integrity Top Hospital, Health System Exec Priority

by Jacqueline Belliveau

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 survey....

68% of Consumers Did Not Pay Patient Financial Responsibility

by Jacqueline Belliveau

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...

Implementing Value-Based Healthcare Revenue Cycle Management

by Jacqueline Belliveau

To align healthcare revenue cycle with value-based reimbursement, healthcare organizations should start by breaking down clinical and financial siloes established by fee-for-service payment models, agreed presenters at Xtelligent Media’s...

Care Standardization Key to Healthcare Revenue Cycle Excellence

by Jacqueline Belliveau

To be named a top health system by Truven Health Analytics and IBM Watson Health, it takes a range of clinical quality improvements and healthcare revenue cycle efficiencies. But for St. Luke’s Health System, one of 15 top health systems...

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