3 key interventions to address lagging payer reimbursements
It seems as if commercial payers are doing all they can to keep from reimbursing providers in a timely manner. According to a recent report by Crowe, 31% of claims submitted to commercial payers in the first quarter of 2023 were not paid for at least three months, as compared with 12% of Medicare claims.…
Insights on population health management challenges through the eyes of C-suite leaders
Population health management is at a crossroads, and one key to ensuring its viability is to bolster stakeholder trust in the potential of value-based payment (VBP) models. That was a key takeaway from healthcare executives who took part in a September panel discussion at the 23rd annual Population Health Colloquium, hosted by the Jefferson College…
Applying AI to revenue cycle management
Three examples of AI applications in healthcare provide insight into how healthcare providers are using the technology today. The organizations are Auburn Community Hospital in Auburn, New York; Banner Health in Phoenix, Arizona; and Community Medical Centers, based in Fresno, California, Addressing RCM staffing shortages: Auburn Community Hospital Auburn Community Hospital, an independent 99-bed rural…
Update: Medicaid DSH payment cut averted as House, Senate pass short-term federal funding
Note: The headline and lead section of this article were updated Oct. 1 with news of a six-week government funding extension that delays the Medicaid DSH cuts and pays for other healthcare programs. The article originally was published Sept. 28 under the headline, “An $8 billion Medicaid DSH cut is closer to happening as a…
How AI is about to change healthcare
For executives who have lived through the marketing of such technological developments as big data, the cloud and the Internet of Things, the prospect of taking on the latest hot concept, AI, might not be appealing. But ignoring AI and all its variations may be a mistake. Although there are different technology solutions being sold…
News Briefs: Reports quantify how cost increases will affect the healthcare industry in 2024
The cost to treat patients will accelerate in the upcoming year, according to newly published projections. PwC’s Health Research Institute reported that the cost of providing care will increase by 7%, up from a 6% increase this year and 5.5% in 2022. A 7% increase would tie 2021 for the highest annual change in the…
Risky business: What every CFO should know before taking on risk
As a health system leader, how can you ensure your organization is making the right moves to take on risk in an evolving landscape for payment? Check out a handful of key capabilities to focus on in this article.
PFC USA’s partnership approach ensures healthcare clients tackle regulatory and patient satisfaction issues
Review some tips from a company with 6.5 years of hands-on experience in helping its healthcare clients handle concerns in healthcare such as workforce shortages and a volatile regulatory environment.
4 common misconceptions about observation that have revenue implications
Among the many things that healthcare providers must document, few are as misunderstood and cause as much confusion as observation. Clearly, observation is often required as part of diagnosing and treating a disease or condition. The challenge for providers is that ambiguity and variability in regulatory and contract language create confusion regarding how to record…
CMS pressures states to restore Medicaid coverage for some beneficiaries who have been disenrolled
CMS says a recent edict to state Medicaid programs has partially stanched the ongoing wave of disenrollments in the program, with about 500,000 beneficiaries set to regain coverage they had lost and “many” others protected from disenrollment going forward. As described in a Sept. 21 summary, 29 states plus Washington, D.C., have acknowledged a systemic…