Revenue Cycle Management

90% of Providers Use Paper, Manual Process for Patient Collections

by Jacqueline LaPointe

Ninety percent of healthcare providers still use paper and manual processes for patient collections, resulting in slower and less successful payment collection, a new survey shows. The findings from...

5 Care Coordination Strategies for Medicare ACO Success

by Jacqueline LaPointe

Embedding care managers in the emergency department, establishing networks of high-performing skilled nursing facilities, and home visits are strategies accountable care organizations (ACOs) are using...

Insurance and Medical Billing Costs for Providers Reaches $282B

by Jacqueline LaPointe

Providers and payers spend about $496 billion on insurance and medical billing costs, with about one-half of the costs being excessive, reveals a new issue brief from the independent policy institute,...

Seasons Have Material Impact on Hospital Revenue Cycle Performance

by Jacqueline LaPointe

Winter, spring, summer, and fall bring more than changes in weather, according to a recent analysis of over 1,000 hospitals. Seasonality also has a significant impact on hospital revenue cycle...

ACOs Seek CMMI Transparency for Downside Financial Risk Adoption

by Jacqueline LaPointe

In an effort to promote downside financial risk adoption, accountable care organizations (ACOs) and other providers are calling on the CMS Innovation Center (CMMI) to increase transparency and improve...

Hospital Profitability Up Despite Volume, Expense Challenges

by Jacqueline LaPointe

Hospital profitability and revenue experienced significant improvement from 2017 to 2018, with operating margins growing by about five percent, a new report from consulting firm Kaufman Hall...

Value-Based Contracts with Risk 3 to 5 Years Away for Providers

by Jacqueline LaPointe

Taking on upside and downside financial risk through value-based contracts is still years away, according to healthcare leaders in a recent survey conducted by HealthCare Executive Group (HCEG) and...

Efficient Hospitals Face Negative Medicare Margins, MedPAC Finds

by Jacqueline LaPointe

Medicare reimbursement rates rarely cover the actual costs of providing hospital care. But now negative Medicare margins are impacting the most efficient hospitals out there, according to a new report...

How Accountable Care Organizations Can Prepare for Downside Risk

by Jacqueline LaPointe

Accountable care organizations (ACOs) are part of the foundation of the healthcare industry’s transition to value-based care and purchasing. Since the passage of the Affordable Care Act (ACA),...

AMA: Health Payers Lagging with Prior Authorization Reform

by Jacqueline LaPointe

Health payers have not made meaningful progress with prior authorization reform, the American Medical Association (AMA) recently argued following the release of their new physician survey. The...

Implementation of Risk-Based Contracts in Healthcare Stalling

by Jacqueline LaPointe

A new survey of more than 500 C-suite executives showed that most organizations are still experimenting with risk-based contracts in healthcare despite having more ambitious goals for implementation by...

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...

EHR Vendor Help Needed for Prior Authorization Improvement

by Jacqueline LaPointe

The Workgroup for Electronic Data Interchange (WEDI) will be calling on the EHR vendor community for prior authorization improvement. “Based upon the findings of the Prior Authorization Council...

Prescription Drug Costs Projected to Rise by 3.8% in 2020

by Jacqueline LaPointe

A national healthcare improvement company and group purchasing organization is projecting a 3.8 percent increase in total prescription drug costs in 2020. In a recent announcement, Premier Inc. stated...

Senator Probes IRS About Non-Profit Hospital Compliance

by Jacqueline LaPointe

Senator Chuck Grassley is looking into non-profit hospital compliance with IRS rules for community health improvement and financial assistance to patients. In a Feb. 19 letter to IRS Commissioner...

21% of Rural Hospitals at High Financial Risk of Closing

by Jacqueline LaPointe

A new analysis from consulting firm Navigant revealed that one-in-five rural hospitals is at high risk of closing based on their current financial position. The analysis of publicly available data...