Expert Reviewed

Articles vetted and approved by hfm magazine editors and industry experts.

How CFOs can bring the rigor of finance to the call center

Health system call centers are universally acknowledged as significant cost centers. Too often, however, they are viewed as non-revenue-generating cost centers. In fact, a call center’s performance also affects revenue growth factors such as clinician utilization and patient loyalty. Despite the multiple ways that call centers affect both the bottom and top lines, there is…

Yuriy Kotlyar October 31, 2023

How a payer-provider collaboration around quality reporting can reduce costs and improve outcomes

Too often today, relations between provider and payer organizations can become contentious around issues related to payment and quality of care. Yet such conflict does not serve patients well, because it deflects these organizations’ attention from their underlying shared purpose: To work together to deliver well-coordinated, cost-effective healthcare to patients. With this purpose in mind,…

Brian Wheeler October 30, 2023

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

Can MRF data be used for comparative benchmarking?

The impetus for the MRF requirement — as outlined by the U.S. Department of Health & Human Services (HHS) in its 2019 hospital price transparency final rule — was to enable informed decision-making about healthcare services based on their pricing, thereby helping to drive down the cost of healthcare. Yet significant obstacles continue to block…

Fred Stodolak September 22, 2023

Key questions for providers after more than 2 years of the price transparency rule

Evidence amassed from over two years of experience with compliance reinforces why providers need to focus on chargemaster prices and self-pay discount policies — and how they can benefit from analyzing trends in consumers’ price searches.

Fred Stodolak August 25, 2023

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

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 struggling to maintain their organizations’ financial sustainability.

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

6 actions for physician practices on signing risk-based contracts

Physician practices are continuing to make the move into value-based payment, and for many, such contracts will present a substantial learning curve. 

Clifford Frank, MHSA May 26, 2023

Care guidance offers a solution for addressing healthcare inequities

Access to healthcare is widely viewed among Americans as being a fundamental right. Yet health inequities continue to deprive many people access to high-quality, affordable care. It is incumbent on U.S. health systems to take the lead in addressing this problem.

Tina Graham May 24, 2023

Enterprisewide physician advisor programs are key to improving costs and revenue cycle performance

Making sure physicians understand the financial implications of how they document their care is critical to a health system’s financial sustainability.

James P. Fee, MD, CCS, CCDS April 26, 2023
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