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

Practice Management News

GAO Identifies VA Provider Productivity Measure Shortcomings

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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...

Beth Israel, Lahey Health Ink Final Healthcare Merger Agreement

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Boston-based Beth Israel Deaconess health system and Lahey Health recently finalized a healthcare merger agreement after about seven months of negotiations. Despite several failed attempts at a healthcare merger in the past, the two health systems...

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

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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

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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...

Long Wait Times Jeopardize Value-Based Purchasing Revenue

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Fee-for-service payment models promote long patient wait times, but providers may want to consider implementing strategies to reduce wait times to increase market share and revenue under value-based purchasing models, argued two Geisinger Health...

Proactive Healthcare Charge Integrity Captures Missed Revenue

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The key to a successful healthcare charge integrity initiative is the ability to trend chargemaster and coding data, stated Harriett Johnson, the Assistant Director of Revenue Integrity at Novant Health. The trending capability allows health...

41% of Rural Hospitals Operating with Negative Margins

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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...

3 Pain Points Affecting Small Practice Healthcare Revenue Cycle

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While working in a small practice allows providers to really understand their patients and their community’s healthcare needs, it can also create unique healthcare revenue cycle management challenges. Small practices come with several advantages....

Hospitals Saw No Effect on Margins After Medicaid Expansion

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The net impact of Medicaid expansion on non-profit hospital finances was close to zero because uncompensated care cost reductions did not offset Medicaid reimbursement shortfalls, a recent AcademyHealth research revealed. After analyzing IRS...

Pediatric Healthcare Costs 35% Less at Community Health Centers

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Pediatric healthcare costs were $1,133 on average among children primarily using community health centers for care versus $1,750 among children seeing other providers, representing a 35 percent difference, a recent Geiger Gibson/RCHN Community...

LA Hospital Pays $42M to Settle Healthcare Fraud, Kickback Case

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Los Angeles-based Pacific Alliance Medical Center recently agreed to pay $42 million in order to settle an ongoing healthcare fraud case involving improper financial relationships between the acute care hospital and referring physicians. According...

Targeting Healthcare Cost Cuts Slows Revenue Cycle Performance

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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

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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

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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

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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...

Hospital Execs Look to Operations to Control Healthcare Costs

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With 78 percent of hospital leaders stating that rising healthcare costs are their primary concern in 2017, the leaders agreed that reviewing and optimizing existing operational and clinical processes was the hospital’s top strategy for...

Care Standardization Key to Healthcare Revenue Cycle Excellence

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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...

ACOs Restructure Healthcare Staffing for High-Risk Patients

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To successfully lower healthcare costs while improving care quality, accountable care organizations (ACOs) have restructured their healthcare staffing models to provide additional support to high-risk patients, a recent American Journal of Accountable...

96% of Healthcare Execs Report Rise in Inpatient Drug Spending

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Approximately 64 percent of healthcare executives reported that inpatient drug spending at their organization significantly increased over the past five years, a recent Premier Inc survey revealed. Another 32 percent said that it somewhat...

Optimizing RCM During Value-Based Reimbursement Transition

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Value-based reimbursement revolutionized how providers get paid for care delivery. However, the slow push away from fee-for-service payments has challenged providers looking to optimize healthcare revenue cycle management. To advance healthcare...

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