Cover Story

September_hfm_cover6 Essential Elements for Physician Revenue Cycle Management

Physician billing operations should not be an afterthought for hospitals and health systems acquiring a physician practice.
By Benjamin C. Colton, David A. Wofford






Using Data Analytics to Identify Revenue at Risk 

Predictive and comparative analytics have the potential to drive improved value by pinpointing areas where proactive steps can better support optimal revenue cycle performance—as well as the organization’s mission. 

By Courtney Thayer, Jerry Bruno, Mary Beth Remorenko

Strategies for Successful Revenue Cycle Outsourcing

Third-party service providers have long performed certain aspects of revenue cycle management, but some hospitals and health systems are now outsourcing the entire process.

By Duane A. Lisowski, Brian Sanderson

Doing Well By Doing Good: Patient Financial Advocacy in Action

By reaching out to uninsured and underinsured patients across the continuum of care, UPMC has increased point-of-service collections, increased financial assistance referrals, obtained medical assistance for many patients, and reduced bad debt.

By April Langford

Improving Pharmacy Revenue Integrity

Billings Clinic worked to identify disconnects between medication purchases, charges, and payment—and has significantly improved coding efficiency and quality.

By Jennifer J. Carmody, Kyle Townsend, Kathy Schwartz

Creating a Positive Culture for Collections

By helping patient financial services personnel feel comfortable asking for money from patients at the time of service, OhioHealth has captured millions of dollars in point- of-service collections—and empowered staff to more effectively help patients resolve their accounts.

By Jane A. Berkebile

Internal Audits Can Safeguard Hospital Revenue

Hospitals can improve their revenue capture by implementing an automated internal audit function that identifies the root causes of denials, thereby helping to prevent the denials from occurring in the first place.

By Barbara Allen

Keeping Step with IRS Guidance on Requirements for Tax-Exempt Hospitals

The IRS issued proposed rules in April regarding community health needs assessments and other requirements that section 501(c)(3) hospitals must meet to maintain tax-exempt status.

By Richard A. Speizman, Alexandra O. Mitchell

Focus Areas


From Medical Home to ACO: A Physician Group's Journey 

The Medical Clinic of North Texas launched a population health initiative in 2010 that has involved working with self-insured companies to manage the health of their employee populations.

By Jay Reddy

Web Extra:Read this web extra to "From Medical Home to ACO: A Physician Group’s Journey" by Jay Reddy and Karen Kennedy


Understanding the Business of Employed Physician Practices 

Health system leaders should understand issues related to finance, compliance, human resources, quality, and safety in their employed physician practices to better support the success of these practices.

By Kathleen D. Sanford


From the Chair

Better Communication Means a Better Revenue Cycle 

Creating a positive patient financial experience is vitally important in the changing healthcare landscape, not only for patient satisfaction, but also for an effective revenue cycle.

By Steven P. Rose, FHFMA, CPA

From the President

Finding the Right Balance 

The private sector seems to be leading the way in reforms aimed at promoting coordinated care—but it’s still a somewhat bumpy road for providers. 

By Joseph J. Fifer, FHFMA, CPA

From the Editor

Confronting the Complex 

Health care is notoriously complex, and some areas of health care are more complex than others. 

By Robert Fromberg, Editor-in-Chief

Eye on Washington

The "Readiness" Debate 

The report issued by the Government Accountability Office in late June that the federal exchanges are behind schedule must have caused substantial disappointment among Affordable Care Act supporters.

By Gail R. Wilensky

Healthcare Value

Achieving Value with Physician Employment 

Without the participation of physicians, a higher-value healthcare system cannot be achieved.

By James H. Landman

Healthcare Reform

Why Pricing Transparency Will Not Reduce Costs 

It is critical to understand what healthcare prices really mean, how consumers respond to price differences, and whether that response might result in cost savings in the long run.

By William B. Weeks

Capital Finance

Thinking Flexibly About Fixed Income 

Large allocations of fixed-income assets in hospitals necessitates a well-articulated fixed income strategy and a good understanding of the potential risks.
By William F. Jarvis

5 Ways To...

5 Ways to Drive Value 

During ANI: The 2013 HFMA National Institute, healthcare thought leaders offered several strategies for driving value in hospitals and health systems.
By Jeni Williams


Member Spotlight: Mind Games

Publication Date: Sunday, September 01, 2013