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

Revenue Cycle Management

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

by Jacqueline LaPointe

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...

Group Purchasing Increases Healthcare Supply Chain Savings

by Jacqueline LaPointe

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...

Provider Profitability Drops Under Biosimilar Use Reimbursement

by Jacqueline LaPointe

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...

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...

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...

Implementing Value-Based Healthcare Revenue Cycle Management

by Jacqueline LaPointe

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...

Care Standardization Key to Healthcare Revenue Cycle Excellence

by Jacqueline LaPointe

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...

Payment Plans Tackle Hospital Patient Collection Challenges

by Jacqueline LaPointe

The growing popularity of high-deductible health plans has wedged many healthcare organizations between a rock and a hard place. Healthcare organizations are struggling to implement patient collection strategies that acquire all of a...

Surviving Solo with Independent Practice Association Support

by Jacqueline LaPointe

Healthcare reform and market forces are driving more independent practice leaders to consolidate with larger hospitals or health systems. But an independent practice association, like Vermont’s HealthFirst, can help solo providers...

Healthcare Framework Aims to Drop Low-Value Resource Use, Costs

by Jacqueline LaPointe

Healthcare organizations looking to reduce low-value resource use and healthcare costs should implement a framework that addresses the patient and clinician interaction, according to a recent Journal of Hospital Medicine report. Four...

Physician Alignment Drives Healthcare Revenue Cycle Progress

by Jacqueline LaPointe

Hospital and health system leaders frequently rank decreasing healthcare costs and increasing efficiency as their top concerns year-after-year. But many healthcare organizations have struggled to implement and sustain healthcare cost...

Healthcare Price Variation a Challenge for State, Local Leaders

by Jacqueline LaPointe

Local leaders may be better positioned to solve healthcare cost challenges than the federal government since healthcare price variation was more significant by state and local markets, a new Health Care Cost Institute (HCCI) and Robert...

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...

Patient Financial Responsibility Not Owed Top Medical Debt Issue

by Jacqueline LaPointe

A recent report from the think tank Frontier Group and the US Public Interest Research Group (PIRG) Education Fund may spell trouble for providers attempting to collect overdue patient financial responsibility either internally or through...

Credit Card On File Program Key To Patient Collections Success

by Jacqueline LaPointe

Implementing a credit card on file program boosted patient collections and reduced accounts receivable by 28 percent in six months at Orthopaedics & Rheumatology of the North Shore, a four-physician specialty practice in...

Boost Healthcare Competition to Drive Down Prices, Up Quality

by Jacqueline LaPointe

The lack of healthcare competition stemming from recent healthcare merger and acquisition trends resulted in higher prices and lower care quality, industry experts recently argued in a Carnegie Mellon University’s Heinz College white...

Healthcare Supply Chain Issues Cause VA Center Director Change

by Jacqueline LaPointe

The VA recently removed its medical center director from his position and temporarily reassigned him to administrative duties after the Office of Inspector General (OIG) reported several patient safety concerns stemming from healthcare...

TN Law Aims to Make Payer Contract Management More Predictable

by Jacqueline LaPointe

Earlier this week, Tennessee Governor Bill Haslam signed the Provider Stability Act into law, which intends to increase transparency and accountability for payer contract management. Effective Jan. 1, 2019, the law will require payers in...

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