To efficiently manage healthcare, it is imperative for systems and management teams to maintain a continuous focus on becoming leaner. Healthcare administrators are responsible for overseeing an increasing number of hospitals, clinics, and medical facilities. Their responsibilities include managing operations, facilities, accounting, and policy, as well as evaluating and recommending new technology to improve patient-centered […]
The number of prior authorization requests continues to increase — despite promises to the contrary by payers — costing physicians time and money. A Medical Group Management Association (MGMA) poll found that 70% of medical groups indicated that prior authorizations increased in the last year. Physicians say that their practices continue to struggle with either […]
Quality metric reporting can be a significant challenge to health care administration due to a number of obstacles. First and foremost, you need buy-in from the physicians providing the care to the patients. Without this, it is difficult to make any meaningful changes to the pattern of care provided. Second, it requires having a very […]
Health care leaders are anticipating a turbulent 2023, according to a report. Staffing, inflation, shrinking margins, and supply chain issues are among the top concerns that will continue to challenge hospitals and health systems and have an outsized effect on overall strategy. Here are the four factors identified as being the most likely to impact […]
The American Hospital Association (AHA) and Better Medicare Alliance (BMA) both support the agency’s effort to improve Medicare Advantage (MA). In an attempt to reform MA, CMS released a proposed rule that aims to streamline prior authorization, promote health equity, and curb deceptive marketing. The Biden administration has shown a commitment to increasing oversight of […]
Provider-sponsored health plans can be naturally aligned with value-based care goals while also being attuned to providers’ needs. Providence Health Assurance’s Medicare Advantage provider-sponsored health plan received a five-star rating through the CMS Medicare Advantage Star Ratings system for the 2022 Medicare open enrollment season. The health plan, which serves Oregon and Washington State, is […]
Improving the customer experience is no longer an idea that’s relegated to the retail or hospitality industries. Now, the idea has gained traction across many industries, including healthcare. For health plans, improving the customer experience and providing member-centric care helps drive member acquisition and retention and improve reimbursement (via a better STARS rating). With so […]
Electronic medical records (EMR) introduced a new era of healthcare management. Should healthcare operators want to venture farther, they may need to consider digitizing their internal operations, as well. Hospitals and clinics present extremely complex environments to manage. There is little wonder that manual and piecemeal approaches to everyday operations are no longer sufficient. Many […]
The Centers for Medicare & Medicaid Services’ Patient-Driven Payment Model (PDPM) takes effect on Oct. 1. When the reform takes effect, long-term post-acute care (LTPAC) facilities will see a big change in how they receive payment for delivering valuable patient care. While the payment reform will inevitably bring challenges, it will also present a significant […]
Building alternative revenue streams source will play a bigger role in healthcare providers’ strategies, according to a new study. Ninety percent of hospital and health system executives surveyed indicated that new revenue streams were an urgent priority expected to yield a return in the next three years, a new study from Boston-based Partners Health Care […]