How principles of 4DX helped a health system transform its revenue cycle
On observing successful applications of the 4 Disciplines of Execution (4DX) across multiple industries, Emory Healthcare undertook an innovative approach in strategically using the performance management tool to solve revenue cycle challenges. Health systems nationwide face profound challenges in the revenue cycle, including those posed by preauthorizations, coding intricacies and payer denials, where solutions often…
6 steps for defining hospital finance to meet today’s pressures and patient needs
Finance functions do not typically make the list of innovations being pursued at hospitals and health systems. In fact, given the stereotype of finance teams having a laser focus on cutting costs and finance leaders being the “no” people, this function is at times perceived as a barrier to innovation. While finance teams must necessarily…
How a focus on fortitude can reduce physician burnout
Healthcare leaders can reduce burnout among physicians and staff by adopting a multifaceted framework to understand the problem, which includes fostering fortitude and addressing individual differences, as well as improving the work environment.
Despite significant challenges, there’s value in hospital mergers
Hospitals are facing severe economic pressures, and the Biden administration's Federal Trade Commission and Department of Justice have intensified enforcement of antitrust laws for hospital mergers, causing many hospitals to abandon their merger plans.
How nonprofit health systems can benefit from post-acute care partnerships
Nonprofit health systems are increasingly partnering with for-profit operators to deliver post-acute care, which is necessary due to margin compression, difficulty in delivering cost-effective care, and lack of core competencies.
How healthcare providers can streamline A/R through partnerships
The efficient management of accounts receivable (A/R) is essential for maintaining the fiscal health and operational effectiveness of any healthcare organization. Finance leaders are increasingly recognizing the benefits of leveraging strategic A/R partnerships to improve revenue cycle operations, decrease costs and boost liquidity. It is imperative, however, that they take a systematic approach to understand…
CMS’s 2024 MA rule brings some improvements but falls short of addressing all providers’ concerns
Hospitals and other healthcare providers welcomed CMS’s release in 2023 of the 2024 Medicare Advantage and Part D final rule (CMS-4201-F).a The rule represents CMS’s effort to refine the practices of MA organizations by placing limitations on prior authorization, elevating requirements for provider directories and making comprehensive adjustments to the MA and Part D quality…
How one health system focused on revenue cycle staff education to improve its denial rate
Many longtime revenue cycle leaders can recall a simpler time when insurance companies sold plans that were broadly accepted by providers in their service areas. Back then, hospitals provided services to patients, billed their health insurance plans and expected relatively prompt payment. This is no longer true. Today’s revenue cycle team members must be knowledgeable…
What health systems need to know about partnering to develop an ASC strategy
Health systems must contend with conflicting imperatives. While remaining intensely focused on day-to-day operations and financial viability, they cannot ignore longer-term strategic imperatives, which may include building out a full continuum of care to succeed under value-based payment while maintaining market relevance. Yet many health systems face significant impediments to broadening the continuum of care,…
Not-for-profit health systems need a new enterprise strategy
Based on findings of recent original research, the current financial performance of not-for-profit (NFP) health systems raises concerns over their long-term financial viability. The research findings underscore the need for NFP health system leaders to reconceptualize their organization as comprising six strategic business units (SBUs) and then manage each in terms of competitiveness. Research findings…