Limiting Emergency Department Denials and Surprise Bills
As health plans introduce new policies affecting emergency department patients, hospital and revenue cycle leaders must be proactive to ensure that patients get the right care—and that claims are handled appropriately.
Your To-Do List When Health Plan Contracts Change
Six steps can help revenue cycle leaders manage health plan changes effectively.
Health Plans, Providers Collaborate on Payment Transformation in Hawaii
More than 500 primary care providers have moved to per-member, per-month payments for patients covered by Hawaii’s largest health plan. The initiative may provide a roadmap for smaller physician practices to participate and flourish in the transition to value.
Sustained Performance Improvement Requires Culture of Excellence
By using a systematic approach to build a culture of continuous improvement and implement Lean principles, health systems can dramatically boost operational performance in quality, safety, and other domains.
UAB Medicine’s Check-in Kiosks Please Patients and Improve Processes
Impressed with the patient-friendly benefits of check-in kiosks at its orthopedic clinic, UAB Medicine has expanded installation to most of its outpatient clinics. The kiosks speed registration, improve data collection, and increase patient payments.
Avoid ED Claim Challenges by Developing CDI Teams
UnitedHealthcare’s new policy of auditing certain emergency department claims should prompt hospitals to seek the expertise of clinical documentation improvement teams in outpatient claim processing.
The Business Case for Fighting Physician Burnout
Mitigating physician burnout may help to reduce turnover and the many costs that come with it, and industry leaders are taking steps to quantify the ROI.
Palliative Care in the ED Improves Value
Although implementing palliative care processes in the ED is challenging initially, such care can reduce avoidable costs and unnecessary suffering.
How Diversity in Executive Teams Contributes to Financial Success
Organizations with high levels of diversity and inclusion perform better on key business metrics, according to a new report and the experiences of health system leaders.
Contracting for Primary Care and Value Improves Patient Outcomes and Lowers Costs
Humana offers primary care practices four types of value-based contracts, but also customizes plans that emphasize population health or other initiatives.