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Financial, clinical, and administrative leaders identify key strategies to drive healthcare value.
Improve your revenue cycle performance through standard metrics, peer comparison, and successful practices.
New HFMA research shows value-driving practices for specific hospital types.
There are a number of legal issues that the move to accountable care raises for hospitals.
Publicly available data from Medicare can help hospitals benchmark their experience against the experiences of their peers to identify unexpected variations and opportunities for improvement.
This fact sheet provides a quick look at the Medicare and Medicaid EHR incentive programs.
One health system managed the implementation of its organizationwide electronic health record by first gaining input from clinicians and working cooperatively with competitors.
The risks of participating in Medicare’s Shared Savings Program would likely exceed the potential benefits if the program unfolds entirely along the lines spelled out in CMS’s proposed rules.
A successful ACO strategy starts with clearly articulating a patient-centered strategic plan that supports organizational goals.
The successful development of ACOs would permit CMS to contract directly with providers in much the same way the agency contracts with insurers under Medicare Advantage.
To assess the risk posed by improper billing, coding, and pricing for pharmacy items, hospital finance leaders should perform an audit of the pharmacy department's charge description master.
There are four key strategies for reducing a provider’s audit risk, with corresponding action steps for each strategy.
An analysis of a set of Medicare RAC appeal decisions rendered by administrative law judges suggests ways that CMS might improve the process.
Outpatient care presents special RAC-related risk, but several steps can mitigate that risk.
Healthcare providers cannot afford to delay their detailed meaningful use planning.
To prepare for a RAC audit, Yale New Haven Hospital has developed a RAC readiness team, created an efficient workflow design, and implemented a new software solution.
There are many factors to consider when evaluating the need for a RAC coordinator. Primary to the decision is the actual volume of requests and dollar amount of revenue at risk.
To meet the challenges presented by recovery audit contractors (RACs), hospitals should perform six tasks that require appropriate investments in staff.
Health systems can expand their primary care reach and reduce costs by collaborating with federally qualified health centers.
A brief summary of the development of the concept of accountable care organizations.
There are four key steps providers can take to position themselves for a RAC audit.
Hospitals can take four key steps to prepare for the challenges of Recovery Audit Contractor audit requests.
As hospitals prepare for a new world of shared payments under the ACO model, they need to make determinations with respect to four key areas of concern: integration, cost versus benefits, patient loyalty, and risks versus rewards.
An analysis of the ACO proposed rule focuses on how the program may affect participants and what hospitals should do to prepare.
CMS is renewing efforts by its contractors to enforce compliance with signature guidelines.
Learn when it is necessary to obtain an advance beneficiary notice (ABN) from a Medicare beneficiary.
Erroneous charges for drugs, if not identified and corrected in a timely manner, can place the hospital at both compliance and financial risk.
Although the recovery audit contractor (RAC) process may be financially terrifying, the RAC preparation process need not be. Here are some tips for smooth sailing through the RAC waters.
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