Category: Revenue Cycle Management

Value-Based Payment Models Can Limit Healthcare Spending

Value-Based Payment Models Can Limit Healthcare Spending

Value-based payment models, including accountable care organizations, bundled payment models, and capitation models, can generate savings for providers and limit healthcare spending. As healthcare spending escalates in the US, stakeholders have started looking at value-based payment models to address rising costs, but many payments are still tied to fee-for-service models, according to a Health Affairs […]
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Hospitals Increased Recruitment and Retention Strategies

Hospitals Increased Recruitment and Retention Strategies

Hospitals are ramping up recruitment and retention strategies as they navigate ongoing workforce shortages and rising expenses. A majority of hospital leaders have increased starting salaries and introduced signing bonuses to attract new employees. The 2022 Healthcare Performance Improvement Report, based on responses from 86 hospital and health system leaders across the U.S., highlights the […]
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Value-Based Care Catching up to Fee-For-Service

Value-Based Care Catching up to Fee-For-Service

Outcomes-based models are spreading, but fee-for-service still dominates payment landscape. Is value-based care having a moment? Health care policy experts and institutions have long agreed that fee-for-service (FFS) medicine is wasteful, outmoded and at least partially responsible for the U.S. spending far more than peer nations on health care, but with outcomes that are no […]
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Hospital Expenses Have Increased 23 Percent Since 2016

Hospital Expenses Have Increased 23 Percent Since 2016

Supply chain issues, medication costs, and labor challenges sparked by the COVID-19 pandemic have contributed to the spiking hospital expenses. Hospital expenses have increased 23 percent since 2016, a spike researchers attributed to continuous COVID-19 challenges, according to a recent analysis. By analyzing American Hospital Association data, investigators noticed hospital expenses increased 47 percent in 2020when […]
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Automating Revenue Cycle Operations Reduces Cost-to-Collect

Automating Revenue Cycle Operations Reduces Cost-to-Collect

Health systems that used automation for revenue cycle operations had an average cost-to-collect of 3.51 percent compared to 3.74 percent for those that did not use automation. Using automation for revenue cycle operations could lower hospital and health systems’ cost-to-collect by 0.25 percent, according to a survey from the Healthcare Financial Management Association (HFMA). The […]
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Low Reimbursement Rates Lead to Rural Hospital Closures

Low Reimbursement Rates Lead to Rural Hospital Closures

Low reimbursement rates, staffing shortages, low patient volumes, and regulatory barriers are some of the root causes of rural hospital closures, the American Hospital Association (AHA) explains in a new report. The report “Rural Hospital Closures Threaten Access: Solutions to Preserve Care in Local Communities” highlights the variety of causes behind rural hospital closures, which […]
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Prior Authorization Reform in Medicare Advantage

Prior Authorization Reform in Medicare Advantage

Prior Authorization reform in Medicare Advantage would help relieve administrative burden for medical groups and reduce patient care delays, MGMA said. The Medical Group Management Association (MGMA) has urged CMS to implement policies that support prior authorization reform and value-based care contracts within the Medicare Advantage program. MGMA submitted comments to CMS Administrator in response […]
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Newly Revised CPT E&M Guidelines: Physician Fee Schedule Proposed Rule

Newly Revised CPT E&M Guidelines: Physician Fee Schedule Proposed Rule

A major revision of the Current Procedural Terminology (CPT) Evaluation and Management (E&M) Guidelines for Office and Outpatient Visits (O/O Visits), Split/Shared Visits, and Critical Care Time billing was implemented Jan. 1, 2021. You would think that all office-based providers would have been made aware of this and changed their documentation accordingly, but there is […]
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