Cover Story

Navigating Performance-Based Risk

A variety of payment models allow hospitals and health systems to chart a course to value-based care by shaping contracts to their specific needs and capabilities.

By James Pizzo, Carlos Bohorquez, Andrew Cohen, Debra Ryan




Mitigating Risks Related to Facilities Management

A healthcare organization can reduce risk and costs by examining the FACTS—the functionality, age, capital constraints, transparency, and sustainability—of its facilities assets. 

By Daniel P. O'Neill, Sydney Scarborough


Overcoming 4 Common Revenue Cycle Benchmarking Myths

Peer group comparisons can help revenue cycle leaders review performance through an external lens, set targets and motivate their teams, and provide informed answers to questions from the C-suite.

By Sandra J. Wolfskill


Revisiting Gainsharing

Value-based payment creates an environment favorable to gainsharing, where hospitals and physicians share savings gained from their combined efforts to reduce waste and improve quality and efficiency.

By Lani Berman


Financing Strategic Plans for Not-for Profits

Developing a plan for capital access to support key initiatives can help not-for-profit health systems better position themselves in a challenging economic environment.

By Laca Wong Hammond, Lorie Damon


How to Reduce the Risk of Purchasing Fraud

Fraud within the purchasing function is costing the healthcare industry millions of dollars annually.

By Lance Mann


TBIs: An Emerging Risk for Health Systems 

Increased national awareness of the risk associated with traumatic brain injuries is raising the likelihood of lawsuits claiming medical negligence in the treatment of these conditions.

By Molly Farrell


Web Extra: Read this web extra to "TBI: An Emerging Risk for Health Systems," by Molly L. Farrell.

Focus Areas

Revenue Cycle

ICD:10 Cracking the Code

Healthcare organizations should address physician clinical documentation improvement now, before the ICD-10 implementation deadline to mitigate ICD-10-related risk and optimize operational processes. 

By Todd M. Husty, Lucy Mancini Newell



How to Manage a Hospital PR Crisis

Hospitals and health systems should take specific steps to ensure they are well prepared for a possible public relations crisis.

By J. Stuart Showalter



From the Chair

Managing Population Health Risk

Providers should be encouraged to be proactive about managing the health of their communities, but they should also guard against overextending themselves or trying to do too much too quickly. 

By Steven P. Rose, FHFMA, CPA


From the President

A Shifting Landscape Means New Priorities for Risk Management

Managing risk is possible if providers and payers work together with shared data and work within their own organizations to make risk management a priority. 

By Joseph J. Fifer, FHFMA, CPA


From the Editor

Ready for Rain

Accepting performance risk is a complex proposition for healthcare organizations, but the payment system is moving inexorably in that direction, making tailored, active preparation a requirement. 

By Robert Fromberg, Editor-in-Chief


Eye on Washington

The IRS and "Your Health Care"

The IRS faces significant challenges in determining and keeping track of individuals’ eligibility for health insurance subsidies under the Affordable care Act. 

By Gail R. Wilensky


Healthcare Value

The Value-Driven Revenue Cycle

Clinical quality improvement depends on the analysis of physician practice data, the accuracy of which is driven largely by high-performing coding and documentation procedures. 

By James H. Landman


Healthcare Reform

Marginal Complications and Healthcare Costs

Health care is burdened with unnecessary spending on labor and capital as it strives to achieve minimum staffing requirements and succeed in an industry in which safety is paramount and expected. 

By Williams B. Weeks


5 Ways To...

5 Ways to Minimize Duplicate Patient Records

Reducing duplicate patient records by 21 percent enabled one health system to achieve cleaner claims and faster cash flow

By Patricia Consolver


Data Trends

National Trends in Charges, Cost, and Medicare IPPS Payment