How a health system can reduce premium labor while building a sustainable workforce
Labor costs are the largest single expense for health systems, and reliance on overtime and contract labor can exacerbate these costs. By addressing premium labor, health systems gain opportunities for increasing staff satisfaction and quality patient care, as well as achieving financial sustainability. Premium labor costs have increased nationally, with contract labor more than doubling…
Why revenue cycle teams must prepare for extended downtime in the age of cyber threats
In today’s volatile cybersecurity landscape, healthcare organizations are under siege. Ransomware, data breaches and cloud outages are no longer rare events — they are persistent threats with enterprisewide consequences. For revenue cycle teams — the financial lifeblood of hospitals — the pernicious effects are immediate: If systems are down, claims don’t go out, cash doesn’t…
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…