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Transformation toward value-based healthcare is reshaping the delivery of care, patient expectations, and payment structures.
Improve your revenue cycle performance through standard metrics, peer comparison, and successful practices.
Under accountable care, participating organizations need to pave new paths to secure payment for the care they provide to patients. The days of the traditional fee-for-service model are gone; payment for accountable care organizations (ACOs) is now contingent on measurably improved health outcomes. The pressure is on to identify effective ways to connect with patients to get better results and earn the most complete, prompt reimbursement possible.
Thankfully, the era of ACOs is aligned with the era of electronic communications. Providers have more ways than ever before to stay in touch with their patients, convey key messages, and personalize information. Even the patient e-statement, sent via email, is now a tool for advanced communications that can support ACOs in their efforts to achieve better outcomes and, thus, receive optimum payment from third-party payers.
Just how can providers use electronic communications to help pave a new path to payment? By adopting electronic delivery of patient statements, providers extend their message-sharing possibilities well beyond the conveyance of basic data. Digital messages sent via email have the potential to be interactive when they are embedded with customized, multimedia tools that can reach recipients in unique, response-inspiring ways. Such interactive messages have the potential to support the ACO model and population health management.
How is this possible? Electronically delivered statements and communications come as attachments in emails. When recipients open the attachments, they are actually accessing secure, personalized online payment portals. These portals can be populated with rich content designed to address specific issues. With videos, hyperlinks to relevant web pages or other websites, customized discharge instructions, disease management tips, or compliance reminders, the options are wide ranging and filled with opportunities to essentially extend patient care beyond the hospital or physician’s office.
Here are three ways to make the most of digitally delivered patient communications.
Communicating with patients with diabetes. Digital messages targeted to patients with diabetes remind patients about suggested ranges for blood sugar levels, recommended testing schedules, and lifestyle choices to support disease management. Messages are timed to be sent at customized intervals for patients. Video content about how to correctly test blood sugar is included, along with interactive question-and-answer sessions to help patients strengthen their knowledge about their disease.
Providing post-surgical follow-up. A hospital can supplement the printed discharge instructions sent home with patients released post-surgery by providing the information again via email. The electronic version of the communication can be enhanced by hyperlinked information about post-surgical care and wellness tips. The discharge information is then followed by additional digital messages that remind patients of upcoming appointments and share information regarding wellness fairs and tips for enhancing health.
Sending breast cancer screening reminders. Providers can prompt patients who are due for breast cancer screenings. The messages may include links to a video for self-screening techniques as well as information on guidelines for having mammograms. The communications also provide information about local Susan G. Komen events.
These kinds of targeted communications aid providers in engaging patients meaningfully to inspire follow-up, wellness, and preventive practices that can lead to enhanced overall outcomes. In addition, digital messaging offers other advantages for providers and patients alike.
Immediacy. Electronically delivered messages get information to patients quickly, offering effective supplements to printed materials that may be distributed at the point of an encounter. Also, e-delivery offers immediate tracking and insights for providers into patient engagement, as data is captured about email opens and click-throughs. This helps to know what is and isn’t working so future messages can be honed to improve interactions.
Affordability. Digital delivery is a cost-effective way to stay in contact with patients over the long term. It eliminates the expenses involved in communications that are printed and mailed to patients’ homes, allowing resources to be channeled elsewhere as needed.
Improved engagement. Digital delivery is on target with the way patients/consumers are coming to expect and accept communications with service providers. As more people receive information on their smartphones, digital delivery grows in relevance, importance, and efficacy.
The effectiveness and efficiencies of e-delivery are highly beneficial in ACO and traditional models of healthcare—for both providers and patients alike.
How can providers get started? Getting started takes commitment, but the rewards are well worth the effort.
Identify technology solutions to support digital delivery. There are technology providers that can offer turnkey solutions to take patient communications digital, including the offering of customized messages specific to recipients’ needs/circumstances. From statement creation and distribution to targeted messaging, technology solutions are available to providers to make the process seamlessly integrated into total patient financial and clinical communications.
Integrate email acquisition at every point of patient communications. Make it standard practice to capture and consistently confirm patient email addresses. Just as physical addresses must be updated, email addresses must be requested and affirmed at every point possible.
Create rich content. Collaborate internally to create/collect quality content to share through digital messaging. As providers offer useful information, articles, and videos, patients will be motivated to trust and interact with messaging. Also, make digital communications two-way communication devices by including methods by which patients can respond, ask, and share; this aids in relationship building that results in deeper interactions over time.
The era of ACOs and electronic communications is a chance for patient-friendly billing practices to shine like never before. And that can lead to better outcomes all around—for patients who need to get and stay well and providers who need to maintain the healthiest revenue cycle possible.
Emdeon is a provider of revenue cycle solutions that combine technology and professional staffing to help ensure healthcare business success.
Publication Date: Friday, January 17, 2014
In this Business Profile, Shawn Yates, director of healthcare product management at Ontario Systems, discusses the growing challenge of managing self-pay accounts and provides insight on how providers can successfully collect patient payments.
In this business profile, Cathy Smith, leader of the revenue transformation consulting practice at The Claro Group discusses how the organization helps hospitals and medical groups reimagine their revenue cycle.
In this business profile, Deloitte & Touche LLP executives Anne Phelps, principal and U.S. healthcare regulatory leader, and Daniel Esquibel, senior manager, explain ways health systems, health plans, and physician practices can prepare for MACRA.
In this Business Profile, Bruce Haupt, president and CEO of ClearBalance, discusses how a patient loan program can increase patient collections, reduce bad debt, and speed cash flow.
In this Business Profile, Jerry Bruno, principal with Deloitte Consulting LLP, discusses the importance of choosing revenue cycle solutions that help an organization meet the challenges of a quickly evolving healthcare environment.
In this business profile, Lane Jackson, a partner in the Grant Thornton LLP Health Care Advisory Services practice, with extensive experience in overseeing system implementations and revenue cycle reorganizations, discusses best practices for elevating revenue cycle performance during an EMR implementation. Grant Thornton LLP is a sponsor of the Large System Controllers Council Affinity Group.
Patient financial engagement is more challenging than ever – and more critical. With patient responsibility as a percentage of revenue on the rise, providers have seen their billing-related costs and accounts receivable levels increase. If increasing collection yield and reducing costs are a priority for your organization, the metrics outlined in this presentation will provide the framework you need to understand what’s working and what’s not, in order to guide your overall patient financial engagement initiatives and optimize results.
No two patients are the same. Each has a very personal healthcare experience, and each has distinct financial needs and preferences that have an impact on how, when and if they chose to pay their healthcare bill. It’s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients. The need to tailor financial conversations and payment options to individual needs and preferences is critical. This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach, but take control of rising collection costs.
This white paper, written by Apex Vice President of Solutions and Services, Carrie Romandine, discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle. Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs, but it will maximize the amount collected before sending to collections. Further, targeted messaging should be applied across all points of patient interaction (i.e. point of service, customer service, patient statements) and analyzed regularly for maximized results.
This white paper, written by Apex President Patrick Maurer, discusses methods to increase patient adoption of online payments. Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections. This white paper shows why patient-centric approaches to online payment portals are important complements to traditional provider-centric approaches.
Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs. This article, written by Apex Founder and CEO Brian Kueppers, explores a number of strategies to create synergy between patient billing, online payment portals and electronic health record (EHR) software to realize a high ROI in speed to payment, patient satisfaction and portal adoption for meaningful use.
Faced with a rising tide of bad debt, a large Southeastern healthcare system was seeing a sharp decline in net patient revenues. The need to improve collections was dire. By integrating critical tools and processes, the health system was able to increase online payments and improve its financial position. Taking a holistic approach increased overall collection yield by 10% while costs came down because the number of statements sent to patients fell by 10%, which equated to a $1.3M annualized improvement in patient cash over a six-month period. This case study explains how.
With the ICD10 deadline quickly approaching and daily responsibilities not slowing down, final preparations for October 1 require strategic prioritization and laser focus.
Read how Gwinnett Medical Center provides clear connections to financial information, offers multiple payment options for patients, and gives onsite staff the ability to collect payments at multiple points throughout the care process.
Read how Orlando Health was able to perform deeper dives into claims data to help the health system see claim rejections more quickly–even on the front end–and reduce A/R days.
To maintain fiscal fitness and boost patient satisfaction and loyalty, healthcare providers need visibility into when and how much they will be paid–by whom–and the ability to better navigate obstacles to payment. They need payment clarity. This whitepaper illuminates this concept that is winning fans at forward-thinking hospitals.
Financial services staff are always looking for ways to improve the verification, billing and collections processes, and Munson Healthcare is no different. Read about how they streamlined the billing process to produce cleaner bills on the front end and helped financial services staff collect more than $1 million in additional upfront annual revenue in one year.
Effective revenue cycle management can be a challenge for any hospital, but for smaller providers it is even tougher. Read how Wallace Thomson identified unreimbursed procedures, streamlined claims management, and improved its ability to determine charity eligibility.
Before launching an energy-efficiency initiative, it’s important to build a solid business case and understand the funding options and potential incentives that are available. Healthcare leaders should consider taking the steps outlined in the whitepaper to ease the process of gaining approval, piloting, implementing, and supporting sustainability projects. You will find that investing in sustainability and energy efficiency helps hospitals add cash to their bottom line. Discover how hospitals and health systems have various options for funding energy-efficient and renewable-energy initiatives, depending on their current financial structure and strategy.
Health care is a dynamic mergers and acquisitions market with numerous hospitals and health systems contemplating or pursuing formal arrangements with other entities. These relationships often pose a strategic benefit, such as enhancing competencies across the continuum, facilitating economies of scale, or giving the participants a competitive advantage in a crowded market. Underpinning any profitable acquisition is a robust capital planning strategy that ensures an organization reserves sufficient funds and efficiently onboards partners that advance the enterprise mission and values.
The success of healthcare mergers, acquisitions, and other affiliations is predicated in part on available capital, and the need for and sources of funding are considerations present throughout the partnering process, from choosing a partner to evaluating an arrangement’s capital needs to selecting an integration model to finding the right money source to finance the deal. This whitepaper offers several strategies that health system leaders have used to assess and manage capital needs for their growing networks.
Announcements from several commercial payers and the Centers for Medicare and Medicaid Services (CMS) early in 2015 around increased efforts to form value-based contracts with providers seemed to point to an impending rise in risk-based contracting. Rather than wait for disruption from the outside in, health care providers are now making inroads on collaborating with payers on various risk-based contracting models to increase the value of health care from within.
Yuma Regional Medical Center (YRMC) is a not-for-profit hospital serving a population of roughly 200,000 in Yuma and the surrounding communities.
Before becoming a ZirMed client, Yuma was attempting to manually monitor hundreds of thousands of charges which led to significant charge capture leakage. Learn how Yuma & ZirMed worked together to address underlying collections issues at the front end, thus increasing Yuma’s overall bottom line.
Kindred Hospital Rehabilitation Services works with partners to audit the market and the facility’s role in that market to identify opportunities for improvement. This approach leads to successes; Kindred’s clinical rehab and management expertise complements our partners’ strengths. Every facility and challenge is unique, and requires a full objective analysis.
As the critical link between patient care and reimbursement, health information enables more complete and accurate revenue capture. This 5-Minute White Paper Briefing shares how to achieve cost-effective revenue integrity by your optimizing HIM systems.
Speedier cash flow starts with better CDI and coding. This 5-Minute White Paper Briefing explains how providers can improve vital measures of technical and business performance to accelerate cash flow.
Qualified coders are getting harder to come by, and even the most seasoned professional can struggle with the complexity of ICD-10. This 5-Minute White Paper Briefing explains how partnerships can help improve coding and other key RCM operations potentially at a cost savings.
The point of managing your revenue cycle isn’t just to improve revenue and cash flow. It’s to do those things effectively by consistently following best practices— while spending as little time, money, and energy on them as possible.
How Lucile Packard Children’s Hospital Stanford increased payments received within 45 days by 20% and reduced paper submission claims by 70% by using ZirMed solutions.
The reasons claims are denied are so varied that managing denials can feel like chasing a thousand different tails. This situation is not surprising given that a hypothetical denial rate of just 5 percent translates to tens of thousands of denied claims per year for large hospitals—where real‐world denial rates often range from 12 to 22 percent. Read about how predictive modeling can detect meaningful correlations across claims denials data.
Emergency Mobile Health Care (EMHC) was founded to be and remains an exclusively locally owned and operated emergency medical service organization; today EMHC serves a population of more than a million people in and around Memphis, answering 75,000 calls each year.
Since the Physician Quality Reporting Initiative (PQRI) introduction, CMS has paid more than $100 million in bonus payments to participants. However, these bonuses ended in 2015; providers who successfully meet the reporting requirements in 2016 will avoid the 2% negative payment adjustment in 2018, so now is the time to act! Included in this whitepaper are implications of increasing patient responsibility, collections best practices, and collections and internal control solutions.
Getting paid what your physician deserves—that’s the goal of every biller. Yet even for the best billers, achieving that success can be elusive when denials stand in the way of success, presenting challenges at every turn. Denials aren’t going away, but you can learn techniques to manage and even prevent them.Join practice management expert Elizabeth W. Woodcock, MBA, FACMPE, CPC, to: Discover methods to translate denial data into business intelligence to improve your bottom line, determine staff productivity benchmarks for billers, and recognize common mistakes in denial management.
Physician practices must improve organizational efficiency to compete in this era of reduced reimbursement and escalating administrative costs.
Many healthcare organizations are pursuing next-generation health information systems solutions. Learn more about Navigant's work with University of Michigan Health System.
The proper implementation of healthcare information technology systems is crucial to an organization’s financial health.
Drive down costs while improving quality in a reform environment.
Receive expert insights and how-to action to achieve and maintain peak revenue cycle performance.
Access expert insights on financial forecasting/planning, strategic partnerships, capital allocation, and more.
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