Out of the back office, into the spotlight: 5 skills revenue cycle leaders need
Healthcare has changed tremendously over the past decade. From increasingly complex payer requirements to growing federal and state regulations to a substantial change in the payer mix (patients are now the second largest payer (27%) behind the federal government (34%), which is mostly Medicare and Medicaid). Today’s revenue cycle is an entirely new animal. What…
Addressing the Rising Patient Payment Obligation: Impact and Strategies amid today’s challenging healthcare environment
In the Fall of 2021, CommerceHealthcare® sponsored a focused survey conducted by the Health Management Academy (HMA), an organization for executives from the nation’s top health systems and leading companies. The HMA survey involved both quantitative polling and in-depth telephone interviews to explore current issues in patient financial experience. This report combines those findings with…
7 KPIs providers should be tracking
Health systems and provider organizations are facing enormous challenges. In a recent poll, providers ranked five of their most pressing issues, which were staffing (58%), expenses (20%), revenue (17%), technology (2%), and other (2%), according to the MGMA. The poll also found that costs have been outpacing revenue for nine in ten respondents. In addition…
The impact of claims denials on the financial health of healthcare
While their hospitals and healthcare centers have long had to deal with claims denials, the number of denied claims continues to rise and payers are showing little inclination to help solve the problem, according to several roundtable participants.
Best practices for relieving unprecedented cost pressures facing healthcare providers
Due to labor cost increases, inflation, declining Medicare reimbursements and other reasons, health systems across the nation are feeling a new financial strain after the height of the pandemic.
Creating sound strategies to manage compensation and benefits regardless of where your employees reside
No doubt there are significant cultural and financial benefits to supporting continued remote and hybrid work in healthcare, particularly in billing/coding, call center, scheduling and administrative roles. Healthcare, however, faces specific challenges as they seek to demystify multi-state tax rules.
Navigating payer practices to reduce denials and enhance outcomes
The friction between payers and providers has existed for decades. It’s understandable to an extent. Payers want to reduce expensive and unnecessary treatment, eliminate fraud and lower financial risk. Providers want to be able to make decisions regarding their patients’ care without having to navigate the hurdles of medical necessity, prior authorization and complex payer…
The patient as the new payer: 5 opportunities to improve the patient financial experience
Patient collections have become an increasingly difficult challenge for hospitals due primarily to a shift in payer mix. Because of rising deductibles and increased patient responsibility, the percentage of healthcare provider revenue collected directly from patients increased to more than 30% from less than 10% over ten years, according to an article from HITLeaders. Faced…
2023 Change and Strategy Research Report
HFMA, with sponsorship from Guidehouse, surveyed 182 health system CFOs, CEOs, and other executives to understand how staffing and patient volumes are expected to change in 2023, and how various market factors may be influencing strategy and goals.
4 tips for simplifying prior authorizations
Healthcare spending in the U.S. has reached what many consider to be unsustainable levels. While spending in other developed nations averaged 8.8% of GDP in 2019, it was nearly double that in the U.S. at 16.8%. One of the major contributors to this spending is administrative waste, which accounts for up to 30% of our…