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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Inflation-Driving-Financial-Challenges-for-Consumers

Inflation Driving Financial Challenges for Consumers

Almost a third of consumers cited inflation as their top reason for being concerned about covering unexpected healthcare costs. More than 70 million adults feel unprepared to pay for healthcare costs, while health systems are facing a tight labor market and ongoing supply chain issues, highlighting the financial repercussions of inflation in the healthcare industry. […]
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Optimizing Revenue Cycle Management Automation

How AI in Optimizing Revenue Cycle Management Automation?

Healthcare Leaders believe that Artificial Intelligence (AI) and Automation have the capability to transform the revenue cycle management process the way we think. Only a robust and durable revenue cycle automation solution is needed to handle all complexities involved in patient eligibility verification to the denial management process. Healthcare provider needs several key steps to […]
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Outsourcing-RCM-Services-can-Lead-to-Better-Outcomes

Outsourcing RCM Services can Lead to Better Outcomes

A report highlights pandemic-related impacts of the past year on revenue cycle challenges. As the labor shortage continues to hamper healthcare organizations, outsourcing has become a common strategy to mitigate costs. Nearly one-third of hospital and health system leaders (63%) have pursued at least one outsourcing solution, with revenue cycle functions at the top of […]
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False-Claims-Act-Allegations

An EHR Vendor to Pay $45M to Resolve False Claims Act Allegations

The U.S. Department of Justice alleges that the EHR vendor accepted and provided “unlawful remuneration in exchange for referrals and by causing its users to report inaccurate information in connection with claims for federal incentive payments.” A developer of electronic health record technology has agreed to pay $45 million to resolve allegations that it violated […]
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Rising Costs - Revenues - Patient Encounters – Physician Practices

Rising Costs, Revenues, Patient Encounters – Physician Practices

How bad is inflation? Physicians, financial managers report the latest. The Medical Group Management Association has published its 2022 MGMA Cost and Revenue Survey Report. The title is “Maintaining Margin in the Inflation Era,” and survey respondents said it’s been difficult to do so in 2022. The COVID-19 pandemic and its lingering effects on health […]
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Hospitals To Take Drastic Cost-Cutting Measures

Hospitals To Take Drastic Cost-Cutting Measures

Economists say hospitals will have to enact “aggressive cost-cutting measures,” including department or service line closures, to stabilize profit margins. Hospitals will need to take drastic cost-cutting measures to stabilize balance sheets after one of the worst financial years in decades, according to economists. Those measures may include department and service line closures or even […]
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Congress-to-Pass-Legislation-to-Limit-Medicare-Payment-Cuts

Congress To Pass Legislation To Limit Medicare Payment Cuts

Waiving the PAYGO sequester requirements and updating the 2023 Medicare Physician Fee Schedule would help limit Medicare payment cuts to hospitals, FAH wrote. As the 117th Congress nears the end of its session, the Federation of American Hospitals (FAH) has called upon congressional leaders to pass legislation that will reduce financial challenges for hospitals, including […]
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Execution-of-Healthcare-Process

How Processes are Really Executed in Healthcare?

In today’s healthcare ecosystem, every health system, hospital and physician is being asked to do more with less. Healthcare providers face increasing pressure to manage revenue, optimize utilization and reduce costs. At the same time, they must also fulfill their primary duties: preventing illness, optimizing care and improving patient outcomes. From clinical decision support systems […]
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