Operational resilience is the revenue cycle management imperative of the OBBBA era
The One Big Beautiful Bill Act (OBBBA) has altered Medicaid eligibility in ways hospitals can no longer treat as a background policy issue. Reverification of Medicaid coverage now happens so frequently that patients lose coverage for administrative reasons that have nothing to do with whether they actually qualify. Much of the industry dialogue has centered…
Ascension systems remain down after cyberattack
Executives with Ascension health system, St. Louis, are keeping in contact with leading law enforcement agencies and industry organizations as they work to restore systems that were shuttered by a cyberattack. The apparent ransomware attack has led to a shutdown of different systems that will last for an undetermined period of time. The attack also…
How predictive analytics and AI shed light on payer behavior
Providers and payers have become more collaborative as payment models evolve toward value. Still, payer-provider relationships can seem one-sided — decidedly in favor of the payer — as hospitals continue to face declining reimbursement and rising costs. The increase in denials is a great example, with rates skyrocketing by 20% over 5 years, according to…
Vanderbilt Health harnesses data to improve revenue cycle management
Close to half of healthcare finance professionals say in a survey that their organizations are experiencing a severe shortage of revenue cycle management (RCM) talent — and many are exploring automation as a way to keep RCM operations working properly. It’s a move that Vanderbilt Health in Nashville, Tennessee, made just prior to the pandemic — and…
Technology
Revamping prior authorization: How AI and automation could boost care and revenue
Prior authorization is the most time-consuming transaction for medical providers, taking up to an hour to complete manually. Find out how providers and health plans can save up to $417 million annually be automating prior authorizations.
Various technical challenges affect hospitals’ ability to fulfill public-health reporting obligations
A report issued by the federal government finds many hospitals struggling to exchange data electronically with public health agencies.
FBI issues alert about ransomware threat affecting healthcare organizations
The Conti ransomware attacks have disrupted healthcare networks in the U.S. and abroad, according to an alert.
‘History favors the bold’: The digital transformation mandate for the healthcare industry
Hospitals and health systems need to implement digital technologies and processes to keep up with societal and industry changes, according to a featured presentation at HFMA’s Digital Annual Conference.
Major insurers roll back no-cost sharing telehealth services
HFMA's Chad Mulvany says patients who received a surprise bill for a telehealth visit will likely blame the provider.