Tag: Expert Reviewed

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…

Ronald Hirsch, MD, FACP, CHCQM September 28, 2023

Why it’s so essential for hospitals to embrace a value-based payment strategy

Few would argue today that U.S. hospitals are facing the most challenging operating conditions in a generation, and perhaps longer. From dealing with myriad severe short-term operating strains, such as workforce shortages, to existential threats to their long-term future, including being cast as the enemy in the fight against rising healthcare costs, hospital leaders are…

Brian Fuller, MA June 12, 2023

AI and machine learning – an intelligent approach to healthcare fraud prevention

The threat of fraud has only become more prevalent in healthcare as a result of three broad trends: Continued growth in the population of healthcare consumers The increase in care being delivered outside of traditional care settings, such as telehealth Exponential development of resources offering health and wellness services Moreover, as the baby boomer generation…

Ellen Zimiles, JD June 9, 2023

Hospitals require an integrated team approach to ensuring revenue integrity

Healthcare organizations cannot expect to achieve financial sustainability without having a deliberate focus on ensuring revenue integrity. Only with such a focus can they deliver programs and services that are essential for coordinating internal efforts to maintain operational efficiency, compliance and optimal payment. For this reason, few finance or revenue cycle leaders would discount its…

Dawn Crump, MA, SSBB, CHC February 28, 2023

Care coordination networks offer path to addressing problems of health inequity

A recently completed initiative in Maryland, called the Health Enterprise Zone project (HEZ), exemplifies how effective care coordination networks can improve quality of care and help reduce costs. Funded by the Maryland Community Health Resource Commission, and implemented by Prince George’s County Health Department, which is headquartered in Largo, Maryland, HEZ reflected a population health…

Caitlin L. Murphy, MSPH, February 24, 2023

3 ways healthcare providers should vet potential private equity partners

As their medical practices returned to near-normal operations recently, more than two years after COVID-19 restrictions were first imposed by the Centers for Disease Control and Prevention (CDC), some practice owners found themselves taking stock of their livelihoods and future prospects. The pandemic caused many of them — including physician groups and health systems —…

Gary Bruce November 20, 2022
googletag.cmd.push( function () { googletag.display( 'hfma-gpt-leaderboard' ); } );