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

Revenue Cycle Management

Advocate, Aurora and Dignity Health, CHI Sign Hospital Merger Deals

by Jacqueline LaPointe

The healthcare market in Chicago is bracing for some major changes starting with the recently announced hospital merger between Advocate Health Care and Wisconsin-based Aurora Health Care. The largest health system in Illinois revealed...

Private Payer A/R, Denials Performance Troubles Hospital Revenue

by Jacqueline LaPointe

Small differences in private payer performance on claims reimbursement and denials can challenge hospital revenue cycles, a new Crowe Horwath analysis of five major commercial managed care payers uncovered. “Many providers focus...

Nearly One-Third of Providers Dissatisfied with Healthcare Costs

by Jacqueline LaPointe

Almost one-third of providers are dissatisfied with the healthcare costs their patients pay for care, according to a recent survey from the University of Utah Health. The national survey of 5,031 patients and 687 physicians revealed that...

Automating Healthcare Contract Management Improves Business Ops

by Jacqueline LaPointe

Improving care access at hospitals is key to ensuring the health of pregnant women and their babies. But the business operations behind improving care access, such as employee and vendor contract management, must be as efficient as...

Type of Provider Data Presented Influences Patient Volume, Choice

by Jacqueline LaPointe

Healthcare consumers who initially prioritized appointment availability when choosing a physician were four times more likely to select a physician based on provider data on quality performance and clinical expertise when presented with...

How Did Providers Respond to Demand After the Affordable Care Act?

by Jacqueline LaPointe

Provider organizations employed additional staff, especially advanced practice clinicians, and expanded facilities and hours in response to increased care demands from more insured patients under the Affordable Care Act, a new Urban...

Tenet Cuts 1,300 Jobs as Part of $150M Cost Reduction Initiative

by Jacqueline LaPointe

Tenet Healthcare Corporation recently announced the elimination of approximately 1,300 jobs as part of the health system’s effort to reduce annual operating costs by $150 million by the end of 2018. The Dallas-based health system...

Healthcare Merger, Acquisition Activity to Rise Despite Slow Q3

by Jacqueline LaPointe

Healthcare mergers and acquisition activity in the third quarter of 2017 may be down by 11 percent compared to last year and 6 percent compared to last quarter. But deal volume still reached over 200 announced transactions for the twelfth...

Health Centers Use Business Tactics to Compete with Private Orgs

by Jacqueline LaPointe

Federally qualified health centers (FQHCs) are the backbone of the healthcare safety net. But rising competition from hospitals and other healthcare organizations may be the straw that breaks that back. FHQCs receive enhanced Medicare and...

Pay-for-Performance Models Hurt Safety-Net Hospital Finances

by Jacqueline LaPointe

Medicare pay-for-performance models may disproportionately penalize safety-net hospitals and other organizations that serve the most vulnerable patient populations, a new study in Medical Care found. Hospitals in one of the most...

Trevor Fetter Steps Down as Tenet Healthcare Corp CEO, Director

by Jacqueline LaPointe

Tenet Healthcare Corporation CEO Trevor Fetter stepped down earlier than expected as head of the health system. He also resigned as director of the company, Tenet recently announced. The health system stated in August 2017 that Fetter...

2017 Hospital Merger Activity Likely to Beat 102 Deals in 2016

by Jacqueline LaPointe

Healthcare organizations engaged in 87 hospital merger and partnership transaction so far in 2017, a recent Kaufman Hall analysis showed. The most recent data revealed that 29 hospital merger and partnership deals were announced in the...

Hospital Mergers Take Two or More Years to Produce Cost Savings

by Jacqueline LaPointe

Hospital mergers and acquisitions resulted in immediate decreases in operating expenses per adjusted admission. However, acquired facilities also saw operating revenue decline at a higher rate, leading to falling operating margins for the...

Tenet Starts Chicago Market Exit with Sale of MacNeal Hospital

by Jacqueline LaPointe

Tenet Healthcare Corporation recently announced that Loyola Medicine has signed a definitive agreement to purchase MacNeal Hospital, one of Tenet’s four hospitals in the Chicago area. Loyola Medicine, an affiliate of Trinity Health,...

$67.4B in Hospital Community Benefit Outweighs Tax Revenue Loss

by Jacqueline LaPointe

Non-profit hospitals and health systems delivered $67.4 billion in community benefit activities in 2013, representing a benefit 11 times greater than the value of the tax revenue forgone by the tax-exempt status of the healthcare...

Does Where Freestanding EDs Operate Change Hospital Payer Mix?

by Jacqueline LaPointe

Freestanding emergency departments (EDs) may be altering the payer mix at the equivalent hospital-based facility because the freestanding EDs tend to be located in areas with greater household incomes and insured rates, stated a recent...

Order History, Machine Ownership Leads to Low-Value Imaging

by Jacqueline LaPointe

Providers are more likely to order costly, low-value imaging services if they have a history of ordering the services, a high rate of imaging in another low-value clinical situation, and an ownership stake in the imaging equipment,...

Hospitals Turn to Bolt-On, Outsourced Revenue Cycle Management

by Jacqueline LaPointe

About 45 percent of large and community hospitals will use multiple core and bolt-on software solutions as part of their organization’s revenue cycle management strategy until 2019, according to a new Black Book survey. On the other...

Healthcare Workforce Demand Growing Faster than Provider Supply

by Jacqueline LaPointe

The demands of the healthcare workforce are significantly outpacing the supply of new doctors available, especially for primary care providers, a recent Merritt Hawkins survey uncovered. The survey of 935 physicians in their final year of...

Healthcare RCM Vendors ZirMed and Navicure Announce Merger

by Jacqueline LaPointe

Healthcare revenue cycle management vendors Navicure and ZirMed recently announced that the organizations signed a definitive agreement to merge. Navicure will supposedly acquire ZirMed in a deal that values at about $750 million, sources...

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