Expert Reviewed

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

Why owning a health plan is a good provider strategy

The trend toward increased ownership of health plans by health systems shows no signs of slowing as health systems are increasingly recognizing the importance of having their primary focus be on health and health outcomes rather than on the number of visits or procedures. A health system leader describes the advantages of health plan ownership and strategic considerations for pursuing this approach.

Scott Nordlund October 21, 2022

New IDS merger aims to improve value and access for its communities

A case study of a merger of two health systems in the Pacific Northwest exemplifies a shift in focus among health system mergers toward creating transformative partnerships aimed at improving value and overall cost effectiveness. The authors recount steps that the new merged integrated delivery system (IDS) has taken to realize the merger’s primary goals.

Tom Kruse October 4, 2022

How Mercyhealth applied automation to fine-tune revenue cycle management

Mercyhealth, a health system based in Rockford, Illinois, was prompted by the COVID-19 pandemic to transform its revenue management processes and pivot to an automated approach that would enable leadership to track effectiveness of staff working at home.

Kimberly Scaccia, CRCR August 31, 2022

To achieve effective nurse staffing, you need CFO-CNO alignment

To respond effectively to ongoing disruptions in the nursing workforce, which have been exacerbated by COVID-19, health system finance and nursing leaders need to come together to find a new financial, clinical and operational approach to improving performance.

Michele Hausman, MBA, RN May 26, 2022

Why health systems may find an acute care at home strategy attractive

The potential for improved outcomes is just one important reason to consider pursuing an acute care at home strategy. Even in the absence of payment, health systems may ultimately find pursuit of such a strategy beneficial.

K. Michael Nichols, FHFMA, CPA May 26, 2022

Strategic alternative dispute resolution offers providers key to substantial claim recoveries

To be able to effectively handle disputes over healthcare claims, providers must be well-informed about the two basic types of alternative dispute resolution that can help them achieve favorable results: arbitration and mediation.

Lawrence A. Laddaga, JD, FHFMA May 5, 2022

3 ways the patient financial experience can improve health equity

COVID-19 shined a bright light on disparities in access to care and health outcomes that existed in the U.S. healthcare system long before the pandemic, but far from improving the situation, it has exacerbated those disparities. Now, health system revenue cycle departments have an opportunity to be part of the solution.

Mark Spinner April 25, 2022

5 ways the ERM playbook for health systems is due for a rewrite

Business risk for health systems has continued to evolve amid huge changes affecting the industry, including those driven by COVID-19. Health system leaders should respond by revisiting their approach to enterprise risk management (ERM) to focus on five areas of risk where their ability to deliver healthcare cost effectively could be compromised: Labor shortages, capital planning amid ongoing change, energy consumption, cyber security and price transparency.

David Burik March 29, 2022

How LifePoint Health revamped its revenue cycle

Executives for the non-urban focused health system wanted to get all of its hospitals using a single revenue cycle management approach.

Jason Ross, MBA March 17, 2022

6 ways to ease physicians’ burden from coding, documentation and risk adjustment

The COVID-19 pandemic has heightened the need for U.S. health systems to gain physician cooperation in documenting and coding patient risk. Yet these organizations also should be mindful of the administrative burden many physicians feel from having to perform these processes, which has contributed to feelings of burnout among them. This article describes six steps hospitals and health systems can take to help ease the administrative burden for physicians, which is necessary to ensure the future quality and effectiveness of the nation’s healthcare system.

Shannon Lukez February 25, 2022
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