An organization’s denial rate is a good barometer of its overall financial health and the soundness of its revenue cycle. A recent survey details how organizations stack up. Although most organizations do a good job of tracking denials by reason, payer, and volume, they miss the mark when communicating information about appeals, appeal success rates, […]
During the Delta and Omicron surges, hospitals and health systems faced significant challenges, prompting AHA to ask Congress for additional COVID-19 financial support. The American Hospital Association (AHA) has urged Congress to provide hospitals and health systems with additional COVID-19 financial support, including more Provider Relief Funds and an extension on the Medicare sequester relief. […]
Patient self-service is key for providers to keep pace with the evolution of healthcare consumerism. Catch a flight recently? Odds are, you booked your tickets online. Visited a bank? There’s a good chance you used an ATM. Just think about the last time you went to the grocery store: How long was the self-checkout line? […]
Proper funding can help your practice to rise above some challenges. 9 Challenges funding can help your medical practice overcome Medical practice funding is often best used to support growth initiatives that will increase your practice’s revenue—thus increasing the chance that you’ll be able to pay off your loan on time. However, sometimes medical practices […]
It was another tumultuous year for the revenue cycle, from the slow burn of price transparency and the fight over surprise billing, to the renewed focus on the workforce, not to mention the continuing COVID-19 pandemic. Here are three issues that defined 2021 for the revenue cycle: PRICE TRANSPARENCY’S SLOW BURN For all the build-up […]
Utah Imaging Associates began notifying nearly 600K of a healthcare data breach, and Eskenazi Health began notifying over 1.5 million individuals. Covered entities must post a notice on the home page of its website for at least 90 days if there are more than 10 individuals with out-of-date contact information to ensure that impacted individuals […]
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 […]
The American Hospital Association (AHA) has asked CMS to include Medicare Advantage organizations in its proposed rule that would streamline the prior authorization process and reduce patient care delays. In December 2020, CMS released a notice of proposed rulemaking about improving prior authorization, following past administrative and clinician struggles. If the rule is finalized, there […]
“Medicare Advantage plans have a unique and growing opportunity to address the needs of socioeconomically vulnerable populations and improve their health,” reports America’s Health Insurance Plans. More plans for individuals with low incomes, as well as targeted SDOH investments and initiatives, round out carrier approaches. On the benefits side, offerings such as meals, transportation, and […]
The data, released Thursday by the Centers for Medicare & Medicaid Services (CMS), come as ACO advocates want the agency to give organizations more options to take on financial risk. CMS has shuttered the program in favor of the Direct Contracting model. “Many Next Gen ACOs aren’t moving into Direct Contracting and have expressed a […]